De-adopting Routine Preoperative Benzodiazepines for Older Surgical Patients (DROP-Benzo)

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University of Pennsylvania

Status

Completed

Conditions

Aging
Surgery

Treatments

Behavioral: Peer Comparison Feedback
Behavioral: Patient Informational Letter

Study type

Interventional

Funder types

Other

Identifiers

NCT05436392
850809

Details and patient eligibility

About

Over 21 million surgical procedures take place among adults aged 65 and older in the US each year, and most older surgical patients in the US now receive benzodiazepines (e.g., midazolam, lorazepam) during anesthesia care. This occurs despite recommendations to avoid these medications in older patients due to associated medical risks and lack of demonstrated benefit. In other words, routine benzodiazepine administration to older surgical patients is likely to represent low-value care that is a suitable target for de-adoption. In this study, we will evaluate a United States Anesthesia Partners (USAP, Dallas, TX) quality improvement initiative using peer comparison feedback to clinicians and/or mailed informational letters to patients as strategies to encourage physician de-adoption of routine preoperative benzodiazepine administration to older surgical patients. In partnership with USAP, this study will be conducted using randomization to evaluate its effect.

Enrollment

517,611 patients

Sex

All

Ages

65+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

All anesthesia clinicians employed by USAP will be included in the evaluation. Patients will be included if they are at least aged 65 and undergo an elective (scheduled) surgical or endoscopic procedure under general anesthesia.

Exclusion criteria

Patients will be excluded if they are unscheduled (urgent/emergent) cases due to inability to reliably deliver study interventions to this group; if they did not receive general anesthesia; or if they received a nerve block procedure.

Trial design

Primary purpose

Health Services Research

Allocation

Randomized

Interventional model

Factorial Assignment

Masking

None (Open label)

517,611 participants in 4 patient groups

Control
No Intervention group
Peer Comparison Feedback
Experimental group
Treatment:
Behavioral: Peer Comparison Feedback
Patient Informational Letter
Experimental group
Treatment:
Behavioral: Patient Informational Letter
Peer Comparison Feedback plus Patient Informational Letter
Experimental group
Treatment:
Behavioral: Patient Informational Letter
Behavioral: Peer Comparison Feedback

Trial contacts and locations

1

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Central trial contact

Annamarie M Horan, PhD; Mark D. Neuman, MD, MSc

Data sourced from clinicaltrials.gov

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