Physician Engagement in EMS Transport Refusal Rates

NCT ID: NCT07107737

Last Updated: 2025-12-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

250 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-01-31

Study Completion Date

2026-09-30

Brief Summary

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The primary goal of this study is to find out if patients who speak with an EMS physician over the phone are less likely to refuse care compare to patients who do not speak with an EMS physician.

Detailed Description

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This study aims to assess the impact of direct physician communication on patients' decisions to refuse EMS transport. The research approach is designed to measure the influence of physician interaction on patient transport decisions in a prospective model. By conducting this research, the study team hopes to provide evidence-based recommendations for EMS protocols regarding patient engagement and refusal management.

Conditions

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Refusal of Transport

Keywords

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EMS transport emergency treatment EMS protocol

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Physician Consultation

Mecklenburg EMS agency (MEDIC) crew chiefs (EMTs and/or paramedics) may decide, based on patient circumstances, to consult OMC for patients wishing to refuse care.

Group Type EXPERIMENTAL

Physician Consultation

Intervention Type BEHAVIORAL

Every other month will be randomized to either Physician Consultation or Standard of Care. During the months designated for Physician Consultation, direct communication between the patient and a designated physician by phone will be implemented when a patient refuses transport in cases where the EMS clinician feels that physician consultation is warranted for further guidance. The physician will attempt to address patient concerns and provide additional medical advice.

Standard of Care

Refusal-of-care consultation not provided to patient

Group Type ACTIVE_COMPARATOR

Standard of Care

Intervention Type BEHAVIORAL

Every other month will be randomized to either Physician Consultation or Standard of Care. During the months designated for Standard of Care, physician intervention will not be provided. For safety reasons, if physicians or EMS MEDIC clinicians feel that speaking with the patient is important to provide additional clinical benefit, they may do so without hesitation and can override the designated intervention month.

Interventions

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Physician Consultation

Every other month will be randomized to either Physician Consultation or Standard of Care. During the months designated for Physician Consultation, direct communication between the patient and a designated physician by phone will be implemented when a patient refuses transport in cases where the EMS clinician feels that physician consultation is warranted for further guidance. The physician will attempt to address patient concerns and provide additional medical advice.

Intervention Type BEHAVIORAL

Standard of Care

Every other month will be randomized to either Physician Consultation or Standard of Care. During the months designated for Standard of Care, physician intervention will not be provided. For safety reasons, if physicians or EMS MEDIC clinicians feel that speaking with the patient is important to provide additional clinical benefit, they may do so without hesitation and can override the designated intervention month.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

• Adult patients ≥18 years old in care of Mecklenburg EMS (MEDIC) on an emergency basis (911 call) who wish to refuse transportation to the hospital in whom MEDIC has, via existing processes and decision-making, engaged online medical control EMS Physicians for further guidance

Exclusion Criteria

* Patients \<18 years old.
* Patient refuses to speak with online medical control EMS Physicians. MEDIC or patient requests to have primary care physician.
* Lack of clinical capacity.
* Incarcerated population.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Wake Forest University Health Sciences

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Stephen Tyler Constantine, MD

Role: PRINCIPAL_INVESTIGATOR

Atrium Health Carolinas Medical Center

Locations

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Atrium Health Carolinas Medical Center

Charlotte, North Carolina, United States

Site Status

Countries

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United States

Central Contacts

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Stephen Tyler Constantine

Role: CONTACT

Phone: 704-355-3181

Email: [email protected]

Facility Contacts

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Stephen Tyler Constantine, MD

Role: primary

Other Identifiers

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IRB00134848

Identifier Type: -

Identifier Source: org_study_id