RECRUITING

Using Reinforcement Learning to Personalize Electronic Health Record Tools to Facilitate Deprescribing

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

The overall goal of the proposed research is to refine and adapt and perform efficacy testing of a novel reinforcement learning-based approach to personalizing EHR-based tools for PCPs on deprescribing of high-risk medications for older adults. The trial will be conducted at Atrius Health, an integrated delivery network in Massachusetts, and will intervene upon primary care providers. The investigators will conduct a cluster randomized trial using reinforcement learning to adapt electronic health record (EHR) tools for deprescribing high-risk medications versus usual care. 70 PCPs will be randomized (i.e., 35 each to the reinforcement learning intervention and usual care \[no EHR tool\] in each arm) to the trial and follow them for approximately 30 weeks. The primary outcome will be discontinuation or ordering a dose taper for the high-risk medications for eligible patients by included primary care providers, using EHR data at Atrius. The primary hypothesis is that the personalized intervention using reinforcement learning will improve deprescribing compared with usual care.

Official Title

Using Reinforcement Learning to Personalize Electronic Health Record Tools to Facilitate Deprescribing

Quick Facts

Study Start:2025-08-11
Study Completion:2026-05-31
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT06660979

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. Age 18 years or older
  2. Willing and able to provide informed consent
  3. Able to understand and follow study procedures
  4. Stable medical condition
  1. * Not a primary care provider at Atrius Health
  2. * Prior randomization to intervention arm in the prior NUDGE-EHR trial

Contacts and Locations

Study Contact

Julie Lauffenburger, PharmD, PhD
CONTACT
617-525-8865
jlauffenburger@bwh.harvard.edu

Study Locations (Sites)

Atrius Health
Boston, Massachusetts, 02215
United States

Collaborators and Investigators

Sponsor: Brigham and Women's Hospital

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2025-08-11
Study Completion Date2026-05-31

Study Record Updates

Study Start Date2025-08-11
Study Completion Date2026-05-31

Terms related to this study

Keywords Provided by Researchers

  • Medication optimization
  • High-risk medications

Additional Relevant MeSH Terms

  • Aging