Safer Use of Antipsychotics in Youth

Completed · Not applicable

Conditions studied: Child Behavior Disorders

In brief

This study tests the effectiveness of an intervention treatment algorithm vs. usual care control in a practical clinical trial. Control arm providers will receive a standard medication alert in the electronic medical record (EMR) when initiating an antipsychotic prescription for an eligible patient. Intervention arm prescribers will receive an interactive medication alert in the EMR when prescribing for eligible patients and the patient and provider will enter the treatment algorithm (provider - medication alert plus clinical review by a child psychiatrist; patient - offer of personalized behavioral health navigation plus bridging therapy when appropriate). The study aims to recruit 800 eligible patients in 4 health systems.

Key facts

Study ID

NCT03448575

Run by

Kaiser Permanente

People needed

733

Starts

2018-03-29

Expected to finish

2021-12-24

Last updated by the study team

2024-10-31

Who can join

Age: 3 and older, up to 17. Sex: any. Healthy volunteers: accepted.

You may qualify if…

• Patient is ≥ 3 and < 18 years of age at the time of the encounter at which the study alert fired (index date);
• Patient is initiating a new episode of outpatient treatment with an antipsychotic medication. (New episodes are defined by no record of an antipsychotic medication being ordered within the health system as part of an outpatient care plan in the prior 180 days);
• Study service (BH navigation, bridging therapy, CAP consult) ordered in Epic for the patient; (e.g., provider removed antipsychotic order and still ordered study services);

You may not qualify if…

• Patient has a diagnosed psychotic disorder, mania, autism spectrum disorder, or intellectual disability;
• Patient was enrolled in the SUAY pilot study;
• The antipsychotic entered is prochlorperazine (Comazol®);
• An outpatient antipsychotic order is entered by a temporary provider in the health system (e.g., "doc of the day"). Orders placed by temporary providers do not count towards the 180 day medication free period for defining a new episode of care.
• The antipsychotic order was placed within an urgent care, emergency department, or inpatient setting (to avoid intervening during a crisis). Orders placed in these settings do not count towards the 180 day medication free period for defining a new episode of care.
• Primary language is not English

Where it is running

• Kaiser Permanente Colorado Institute for Health Research — Aurora, Colorado, United States
• Nationwide Children's Hospital / Partners for Kids — Columbus, Ohio, United States
• Kaiser Permanente Center for Health Research - Northwest — Portland, Oregon, United States
• Kaiser Permanente Washington Health Research Institute — Seattle, Washington, United States

Full record on ClinicalTrials.gov

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