Trial Outcomes & Findings for RxConnect User Testing Study (NCT NCT05493072)

NCT ID: NCT05493072

Last Updated: 2025-03-24

Results Overview

Sub analysis of errors by type available in full report

• Recruitment status: COMPLETED
• Study phase: NA
• Target enrollment: 24 participants
• Primary outcome timeframe: 60 minutes
• Results posted on: 2025-03-24

Participant Flow

Participant milestones

Measure	1 - Control First, Then Intervention Observation of control arm practice for 5 medication scenarios (using standard prescribing practice), then intervention arm for 5 medication scenarios (using the intevention to support prescribing practice).	2- Intervention First, Then Control Observation of intervention arm for 5 medication scenarios (using the intevention to support prescribing practice). Then Observation of control arm practice for 5 medication scenarios (using standard prescribing practice)
Overall Study STARTED	12	12
Overall Study COMPLETED	12	12
Overall Study NOT COMPLETED	0	0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Measure	All Study Participants n=24 Participants All study participants exposed to both control and intervention, therefore reported together
Age, Categorical <=18 years	0 Participants n=24 Participants
Age, Categorical Between 18 and 65 years	24 Participants n=24 Participants
Age, Categorical >=65 years	0 Participants n=24 Participants
Sex/Gender, Customized Gender · Female	15 Participants n=24 Participants
Sex/Gender, Customized Gender · Male	8 Participants n=24 Participants
Sex/Gender, Customized Gender · Not stated	1 Participants n=24 Participants
Profession Doctor	20 Participants n=24 Participants
Profession Pharmacist	4 Participants n=24 Participants
Speciality Paediatric Emergency	1 Participants n=24 Participants
Speciality Paediatric Intensive Care Unit	4 Participants n=24 Participants
Speciality Paediatrics	9 Participants n=24 Participants
Speciality Adults	10 Participants n=24 Participants
Participant grade (self reported titles used) Foundation Year 1	1 Participants n=24 Participants
Participant grade (self reported titles used) Senior House Officer	1 Participants n=24 Participants
Participant grade (self reported titles used) CT/ST Years 1-5	5 Participants n=24 Participants
Participant grade (self reported titles used) ST Years 6-8	6 Participants n=24 Participants
Participant grade (self reported titles used) Registrar	1 Participants n=24 Participants
Participant grade (self reported titles used) Clinical Fellow	3 Participants n=24 Participants
Participant grade (self reported titles used) Trust Grade	2 Participants n=24 Participants
Participant grade (self reported titles used) Consultant	1 Participants n=24 Participants
Participant grade (self reported titles used) Pharmacist Pay Band 8A	1 Participants n=24 Participants
Participant grade (self reported titles used) Pharmacist Pay Band 8B	3 Participants n=24 Participants
Years using Cerner <1 year	6 Participants n=24 Participants
Years using Cerner 1-2 years	2 Participants n=24 Participants
Years using Cerner 2-3 years	6 Participants n=24 Participants
Years using Cerner 3-4 years	2 Participants n=24 Participants
Years using Cerner 4-5 years	2 Participants n=24 Participants
Years using Cerner 5+ years	6 Participants n=24 Participants

PRIMARY outcome

Timeframe: 60 minutes

Sub analysis of errors by type available in full report

Outcome measures

Measure	RxConnect (Experiment Arm) n=120 Medication orders Participants were asked to complete 5 test scenarios using Touchdose to determine the required dose recommendation. Participants were asked to 'trust' Touchdose and were reminded that they were not required to check or confirm the dose recommendations with any other resources or calculators. Participants entered the dose recommendation for each medication scenario for the required test patient on the Cerner Millennium Power Chart currently used at the study site for electronic prescribing.	Current Practice (Control) Arm n=120 Medication orders Participants were asked to complete 5 test scenarios using the usual resources available to them in their prescribing practice. Access was provided to the prescribers usual electronic prescribing platform, including links to the British National Formulary, MedicinesComplete, local antimicrobial stewardship application, local intranet, and a generic online search engine. A hard copy of the BNF and BNFc was also readily available. Participants entered the dose recommendation for each medication scenario for the required test patient on the Cerner Millennium Power Chart currently used at the study site for electronic prescribing.
Number of Prescribing Errors by Study Arm Erroneous medication order	8 Medication orders	34 Medication orders
Number of Prescribing Errors by Study Arm Dose error	8 Medication orders	31 Medication orders
Number of Prescribing Errors by Study Arm Route error	3 Medication orders	4 Medication orders
Number of Prescribing Errors by Study Arm Patient error	0 Medication orders	1 Medication orders
Number of Prescribing Errors by Study Arm Frequency error	0 Medication orders	3 Medication orders
Number of Prescribing Errors by Study Arm Formulation error	3 Medication orders	6 Medication orders

SECONDARY outcome

Timeframe: 60 minutes

Dosing errors with a deviation of more than 25% from the recommended range were categorised as large magnitude errors.

Outcome measures

Measure	RxConnect (Experiment Arm) n=120 Medication orders Participants were asked to complete 5 test scenarios using Touchdose to determine the required dose recommendation. Participants were asked to 'trust' Touchdose and were reminded that they were not required to check or confirm the dose recommendations with any other resources or calculators. Participants entered the dose recommendation for each medication scenario for the required test patient on the Cerner Millennium Power Chart currently used at the study site for electronic prescribing.	Current Practice (Control) Arm n=120 Medication orders Participants were asked to complete 5 test scenarios using the usual resources available to them in their prescribing practice. Access was provided to the prescribers usual electronic prescribing platform, including links to the British National Formulary, MedicinesComplete, local antimicrobial stewardship application, local intranet, and a generic online search engine. A hard copy of the BNF and BNFc was also readily available. Participants entered the dose recommendation for each medication scenario for the required test patient on the Cerner Millennium Power Chart currently used at the study site for electronic prescribing.
Number of Medication Orders With a Large Magnitude Error (Greater Than 25% of the Recommended Dosing Range)	6 Medication orders	22 Medication orders

SECONDARY outcome

Timeframe: 60 minutes

For the first scenario, TTP was calculated from the moment the participant began reading the scenario to task completion, while for subsequent scenarios, timing started from the completion of the previous scenario. The endpoint for each scenario was marked by the participant's submission of the medication order on the electronic prescribing (eP) system.

Outcome measures

Measure	RxConnect (Experiment Arm) n=110 Medication orders Participants were asked to complete 5 test scenarios using Touchdose to determine the required dose recommendation. Participants were asked to 'trust' Touchdose and were reminded that they were not required to check or confirm the dose recommendations with any other resources or calculators. Participants entered the dose recommendation for each medication scenario for the required test patient on the Cerner Millennium Power Chart currently used at the study site for electronic prescribing.	Current Practice (Control) Arm n=110 Medication orders Participants were asked to complete 5 test scenarios using the usual resources available to them in their prescribing practice. Access was provided to the prescribers usual electronic prescribing platform, including links to the British National Formulary, MedicinesComplete, local antimicrobial stewardship application, local intranet, and a generic online search engine. A hard copy of the BNF and BNFc was also readily available. Participants entered the dose recommendation for each medication scenario for the required test patient on the Cerner Millennium Power Chart currently used at the study site for electronic prescribing.
Time Taken to Prescribe Each Medication	179.7 seconds Interval 166.1831 to 193.2897	224.8 seconds Interval 205.2554 to 244.3992

SECONDARY outcome

Timeframe: 60 minutes

Measurement of the Prescribers perceived mental load per prescribing scenario, Using NASA task load index (TLX).

An overall workload score combining all 6 NASA TLX domains was calculated (minimum 0 lower workload - maximum 126 highest workload).

Outcome measures

Measure	RxConnect (Experiment Arm) n=24 Participants Participants were asked to complete 5 test scenarios using Touchdose to determine the required dose recommendation. Participants were asked to 'trust' Touchdose and were reminded that they were not required to check or confirm the dose recommendations with any other resources or calculators. Participants entered the dose recommendation for each medication scenario for the required test patient on the Cerner Millennium Power Chart currently used at the study site for electronic prescribing.	Current Practice (Control) Arm n=24 Participants Participants were asked to complete 5 test scenarios using the usual resources available to them in their prescribing practice. Access was provided to the prescribers usual electronic prescribing platform, including links to the British National Formulary, MedicinesComplete, local antimicrobial stewardship application, local intranet, and a generic online search engine. A hard copy of the BNF and BNFc was also readily available. Participants entered the dose recommendation for each medication scenario for the required test patient on the Cerner Millennium Power Chart currently used at the study site for electronic prescribing.
Measurement of the Prescribers Perceived Mental Load Per Prescribing Scenario	41.45 score on a scale Interval 33.02 to 49.89	57.21 score on a scale Interval 48.69 to 65.72

OTHER_PRE_SPECIFIED outcome

Timeframe: 60 minutes

Erroneous orders identified as a primary outcome of the study will then be analysed using hierarchical task analysis (HTA). The HTA is a qualitative outcome, different from the primary outcome (error yes/no) by instead identifying 'where' within the prescribing process an error occurred.

Workflow steps, representing tasks or actions in both the control and intervention arms, were developed based on established and anticipated prescribing workflows and refined as new, unanticipated steps emerged during study observations. These workflows were then employed for hierarchical task analysis, as detailed in the data analysis section.

Hierarchical task analysis was conducted by reviewing recordings of all erroneous medication orders, breaking down the prescribing process into discrete steps. This structured approach allowed for identification of potential risks or inefficiencies in the workflow, helping trace each error's likely origin within the process.

Outcome measures

Measure	RxConnect (Experiment Arm) n=120 Medication orders Participants were asked to complete 5 test scenarios using Touchdose to determine the required dose recommendation. Participants were asked to 'trust' Touchdose and were reminded that they were not required to check or confirm the dose recommendations with any other resources or calculators. Participants entered the dose recommendation for each medication scenario for the required test patient on the Cerner Millennium Power Chart currently used at the study site for electronic prescribing.	Current Practice (Control) Arm n=120 Medication orders Participants were asked to complete 5 test scenarios using the usual resources available to them in their prescribing practice. Access was provided to the prescribers usual electronic prescribing platform, including links to the British National Formulary, MedicinesComplete, local antimicrobial stewardship application, local intranet, and a generic online search engine. A hard copy of the BNF and BNFc was also readily available. Participants entered the dose recommendation for each medication scenario for the required test patient on the Cerner Millennium Power Chart currently used at the study site for electronic prescribing.
Erroneous Medication Orders by Hierarchial Task Analysis (Identifying Vulnerable Steps in the Prescribing Workflow). Enter/confirm dose	1 Medication orders	0 Medication orders
Erroneous Medication Orders by Hierarchial Task Analysis (Identifying Vulnerable Steps in the Prescribing Workflow). Overall erroneous medication orders	8 Medication orders	34 Medication orders
Erroneous Medication Orders by Hierarchial Task Analysis (Identifying Vulnerable Steps in the Prescribing Workflow). Review written patient scenario	5 Medication orders	8 Medication orders
Erroneous Medication Orders by Hierarchial Task Analysis (Identifying Vulnerable Steps in the Prescribing Workflow). Access prefered/necesary dosing resource	0 Medication orders	1 Medication orders
Erroneous Medication Orders by Hierarchial Task Analysis (Identifying Vulnerable Steps in the Prescribing Workflow). Identify medication, appropriate indication and dose recommendation	0 Medication orders	7 Medication orders
Erroneous Medication Orders by Hierarchial Task Analysis (Identifying Vulnerable Steps in the Prescribing Workflow). Identify any relevant dose considerations	0 Medication orders	12 Medication orders
Erroneous Medication Orders by Hierarchial Task Analysis (Identifying Vulnerable Steps in the Prescribing Workflow). Calculate dose as per resource directions	0 Medication orders	3 Medication orders
Erroneous Medication Orders by Hierarchial Task Analysis (Identifying Vulnerable Steps in the Prescribing Workflow). Condsider if any min/max dose constraints need taking into account	0 Medication orders	1 Medication orders
Erroneous Medication Orders by Hierarchial Task Analysis (Identifying Vulnerable Steps in the Prescribing Workflow). Select/search for or confirm route from unfiltered list	0 Medication orders	1 Medication orders
Erroneous Medication Orders by Hierarchial Task Analysis (Identifying Vulnerable Steps in the Prescribing Workflow). Select/search for form from unfiltered list	0 Medication orders	1 Medication orders
Erroneous Medication Orders by Hierarchial Task Analysis (Identifying Vulnerable Steps in the Prescribing Workflow). Launch required patient in Cerner	1 Medication orders	0 Medication orders
Erroneous Medication Orders by Hierarchial Task Analysis (Identifying Vulnerable Steps in the Prescribing Workflow). Select one or more dose recommendation(s)	1 Medication orders	0 Medication orders

OTHER_PRE_SPECIFIED outcome

Timeframe: 60 minutes

Population: There is only one arm reported for the qualitative feedback as all participants provided feedback.

Audio of interviews will be transcribed verbatim and thematically analyses to provide insights from participants that can be utilised for recommendations for practice and research.

Outcome measures

Measure	RxConnect (Experiment Arm) n=24 Participants Participants were asked to complete 5 test scenarios using Touchdose to determine the required dose recommendation. Participants were asked to 'trust' Touchdose and were reminded that they were not required to check or confirm the dose recommendations with any other resources or calculators. Participants entered the dose recommendation for each medication scenario for the required test patient on the Cerner Millennium Power Chart currently used at the study site for electronic prescribing.	Current Practice (Control) Arm Participants were asked to complete 5 test scenarios using the usual resources available to them in their prescribing practice. Access was provided to the prescribers usual electronic prescribing platform, including links to the British National Formulary, MedicinesComplete, local antimicrobial stewardship application, local intranet, and a generic online search engine. A hard copy of the BNF and BNFc was also readily available. Participants entered the dose recommendation for each medication scenario for the required test patient on the Cerner Millennium Power Chart currently used at the study site for electronic prescribing.
Number of Participants That Gave Qualitative Feedback	24 participants	—

Adverse Events

Current Practice (Control Arm)

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

RxConnect (Experiment Arm)

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Calandra Feather

Imperial College NHS Healthcare Trust

Phone: 07977185577

Email: calandra.feather@nhs.net

Results disclosure agreements

• Principal investigator is a sponsor employee
• Publication restrictions are in place