Evaluating alert fatigue over time to EHR-based clinical trial alerts: findings from a randomized controlled study

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Clinical trials are essential to the advancement of medicine, and research participant recruitment is critical to successful trial conduct. Unfortunately, difficulties achieving recruitment goals are common, and failure to meet such goals can impede the development and evaluation of new medical therapies.1 2 It is well recognized that physicians often play a vital role in the recruitment of participants for certain trials. However, barriers including time constraints, unfamiliarity with available trials, and difficulty referring patients to trials, often make it challenging to recruit during routine practice.3–6 Consequently, most clinicians do not engage in traditional recruitment activities and recruitment rates suffer.4 6

 

The increasing availability of electronic health records (EHRs) presents an opportunity to address the issue of inadequate recruitment for clinical trials by leveraging the information and decision support resources often built into such systems. Indeed, recent studies of EHR-based, point-of-care, clinical trial alerts (CTA) have demonstrated they have the potential to improve recruitment rates when applied to clinical trials.7–9 Despite their promise and the fact that they have been well tolerated in recent studies, CTAs like any point-of-care alert do have the potential for misuse, and further study is needed to better understand and inform their appropriate, widespread use.10 One important but poorly understood aspect relates to the performance characteristics of such alerts, particularly the issue of clinician responsiveness to alerts over time, and the implications of such phenomena on alert design and deployment decisions.

 

source: http://jamia.bmj.com/content/early/2012/04/24/amiajnl-2011-000743.long

 

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