The INSPIRE-ASP UTI Trial

Harvard Pilgrim Health Care

Status: Completed

Conditions: Urinary Tract Infection (UTI)

Treatments: Other: INSPIRE CPOE Smart Prompt; Other: Routine Care

Study type: Interventional

Funder types: Other; Other U.S. Federal agency; Industry

Identifiers

NCT03697096

PH000619B_UTI

Details and patient eligibility

About

The INSPIRE-ASP UTI trial is a cluster-randomized controlled trial of HCA hospitals comparing routine empiric antibiotic stewardship practices with real-time precision medicine computerized physician order entry smart prompts providing the probability that a non-critically ill adult admitted with UTI is infected with a resistant pathogen.

Note: that enrolled "subjects" represents 59 individual HCA hospitals that have been randomized.

Enrollment: 55,412 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Facility Inclusion Criteria:

• HCA hospitals admitting adults for UTI
• Facility use of MEDITECH as their electronic health record system

Facility Exclusion Criteria:

Note: unit of randomization is the hospital, however the CPOE alert intervention will calculate risk estimates for adults age >=18 admitted to non-ICU wards and who are ordered to receive extended-spectrum antibiotics for UTI. Prisoners were excluded from prompts and analysis.

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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55,412 participants in 2 patient groups

Routine Care

Active Comparator group

Description:

Continued routine antibiotic stewardship strategies.

Treatment:

Other: Routine Care

INSPIRE CPOE Smart Prompt

Active Comparator group

Description:

Use of a computerized physician order entry (CPOE) smart prompt alert to guide empiric choice of antibiotics for UTI in non-ICU patients in the first 3 days of hospitalization.

Treatment:

Other: INSPIRE CPOE Smart Prompt