Advancing Strategies to Optimize the PerIopeRativE Management of PostOperative Nausea and Vomiting (ASPIRE-PONV) Trial

NCT ID: NCT07152249

Last Updated: 2025-11-12

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

RECRUITING

Clinical Phase

NA

Total Enrollment

13120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-09-03

Study Completion Date

2026-09-30

Brief Summary

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The goal of this prospective, unblinded, pragmatic and repeated crossover trial is to learn if clinical decision support alerts will impact postoperative nausea and vomiting (PONV) prophylaxis and reduce PONV rates in adult patients who have planned surgery with general anesthesia. The main aim is to improve PONV, establishing a scalable Clinical Decision Support (CDS) Tool for personalized PONV prevention.

The primary hypothesis is that, compared with standard care, the Anesthesia Workflow-Driven Clinical Decision Support Tool for Personalized PONV Prevention will be associated with a significant improvement in the rate of appropriate administration of PONV prophylaxis and a significant decrease in the incidence of PONV.

This study will evaluate a new clinical decision support (CDS) tool designed to improve how and when PONV prevention strategies are used. Unlike traditional tools that provide generic, one-time alerts, this new system is integrated into the electronic health record (EHR) and delivers timely, targeted reminders to anesthesia providers at key moments during a patient's surgical care-such as before surgery begins, after anesthesia is given, and before the patient wakes up. These alerts are based on each patient's individual risk for PONV and are intended to support, not replace, clinical judgment. The study will use a crossover design over 12 months, alternating between periods when the tool is active and when it is not. The goal is to determine whether this time-sensitive, workflow-integrated tool can lead to better adherence to best practices and improved patient outcomes.

Detailed Description

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Conditions

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Postoperative Nausea Postoperative Vomiting

Keywords

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clinical decision support

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

This trial will use a repeated crossover design. The planned 12-month period of enrollment will be divided into four 12 -week blocks (10 weeks of control or intervention followed by a 2-week washout period).
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Control

No intervention will be delivered.

Group Type NO_INTERVENTION

No interventions assigned to this group

Anesthesia Workflow-Driven Clinical Decision Support (AW-D CDS) Tool Intervention

The AW-D CDS Tool will test the delivery of PONV prophylaxis with the use of the clinical decision support tool. When a patient meets the study study criteria, the AW-D CDS Tool will provide automated notification through the electronic health system.

The automated notifications be triggered and linked to the point-of-care/desired time of PONV medication administration throughout the workflow of the anesthetic case to optimize the timing of PONV medication administration (pre-procedure evaluation, post-induction, pre-emergence).

The provider is not forced to follow the recommendations, rather it serves as a reminder of best practices as defined by our department.

The intervention will be assessed using a repeated cross-over design at the institutional level with periods of time for washout, control and study intervention.

Group Type EXPERIMENTAL

AW-D Clinical Decision Support Tool

Intervention Type OTHER

The AW-D Clinical Decision Support Tool will test the automatic delivery of best practice advisories for antiemetic medications at critical timepoints in the perioperative period.

Interventions

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AW-D Clinical Decision Support Tool

The AW-D Clinical Decision Support Tool will test the automatic delivery of best practice advisories for antiemetic medications at critical timepoints in the perioperative period.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18 years
* Planned surgery with general anesthesia with endotracheal intubation or laryngeal mask airway
* Meet zero or more risk factors for PONV ( history of motion sickness or postoperative nausea and vomiting, non-smoker, female sex, duration of inhalation anesthesia greater than 1 hour, undergoing high risk surgical procedure (cholecystectomy, laparoscopy, gynecologic), and perioperative opioid use)


Any operating room anaesthesia provider of eligible patients will be included.

Exclusion Criteria

* ASA 6 including organ procurement,
* Patients anticipated to be transferred directly to the intensive care unit intubated,
* Procedure types:

* Electroconvulsive therapy,
* Intubation only cases,
* labor epidurals,
* transesophageal echocardiography (TEE)/cardioversion,
* surgery duration \< 30 minutes.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Vanderbilt University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Miklos Kertai

Professor Cardiothoracic Anesthesiology, Vice Chair Perioperative Medicine, Director Perioperative Precision Medicine Program

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Miklos Kertai, M.D., Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Vanderbilt University Medical Center

Locations

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Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Miklos Kertai, M.D., Ph.D.

Role: CONTACT

Phone: 615-875-0378

Email: [email protected]

Gail Mayo

Role: CONTACT

Phone: 615-936-1705

Email: [email protected]

Facility Contacts

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Miklos Kertai, MD

Role: primary

Ellen Stallings

Role: backup

Other Identifiers

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250773

Identifier Type: -

Identifier Source: org_study_id