Primary Care Clinician Commitments to Choosing Wisely®
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The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. |
ClinicalTrials.gov Identifier: NCT02247050 |
Recruitment Status :
Completed
First Posted : September 23, 2014
Last Update Posted : May 6, 2016
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Health Services Misuse Physician's Practice Patterns Guideline Adherence Unnecessary Procedures Health Care Costs | Behavioral: Commitment invitation | Not Applicable |

Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 45 participants |
Allocation: | Randomized |
Intervention Model: | Crossover Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Health Services Research |
Official Title: | Primary Care Clinician Commitments to Choosing Wisely® |
Study Start Date : | September 2014 |
Actual Primary Completion Date : | March 2015 |
Actual Study Completion Date : | June 2015 |
Arm | Intervention/treatment |
---|---|
Experimental: Commitment invitation at time 1
Intervention: Behavioral: Commitment Invitation In the stepped wedge cluster randomized design, the first clinic will remain in the control period (no intervention) for 2 months and then cross over to the intervention period for 6 months. |
Behavioral: Commitment invitation
Clinicians will be invited to commit to follow 3 Choosing Wisely recommendations. Those that choose to commit will also receive point-of-care commitment reminders, point-of-care Choosing Wisely patient education handouts, and weekly emails with decision support resources. |
Experimental: Commitment invitation at time 2
Intervention: Behavioral: Commitment Invitation In the stepped wedge cluster randomized design, the second clinic will remain in the control period (no intervention) for 3 months and then cross over to the intervention period for 5 months. |
Behavioral: Commitment invitation
Clinicians will be invited to commit to follow 3 Choosing Wisely recommendations. Those that choose to commit will also receive point-of-care commitment reminders, point-of-care Choosing Wisely patient education handouts, and weekly emails with decision support resources. |
Experimental: Commitment invitation at time 3
Intervention: Behavioral: Commitment Invitation In the stepped wedge cluster randomized design, the third clinic will remain in the control period (no intervention) for 4 months and then cross over to the intervention period for 4 months. |
Behavioral: Commitment invitation
Clinicians will be invited to commit to follow 3 Choosing Wisely recommendations. Those that choose to commit will also receive point-of-care commitment reminders, point-of-care Choosing Wisely patient education handouts, and weekly emails with decision support resources. |
Experimental: Commitment invitation at time 4
Intervention: Behavioral: Commitment Invitation In the stepped wedge cluster randomized design, the fourth clinic will remain in the control period (no intervention) for 5 months and then cross over to the intervention period for 3 months. |
Behavioral: Commitment invitation
Clinicians will be invited to commit to follow 3 Choosing Wisely recommendations. Those that choose to commit will also receive point-of-care commitment reminders, point-of-care Choosing Wisely patient education handouts, and weekly emails with decision support resources. |
Experimental: Commitment invitation at time 5
Intervention: Behavioral: Commitment Invitation In the stepped wedge cluster randomized design, the fifth clinic will remain in the control period (no intervention) for 6 months and then cross over to the intervention period for 2 months. |
Behavioral: Commitment invitation
Clinicians will be invited to commit to follow 3 Choosing Wisely recommendations. Those that choose to commit will also receive point-of-care commitment reminders, point-of-care Choosing Wisely patient education handouts, and weekly emails with decision support resources. |
Experimental: Commitment invitation at time 6
Intervention: Behavioral: Commitment Invitation In the stepped wedge cluster randomized design, the sixth clinic will remain in the control period (no intervention) for 7 months and then cross over to the intervention period for 1 month. |
Behavioral: Commitment invitation
Clinicians will be invited to commit to follow 3 Choosing Wisely recommendations. Those that choose to commit will also receive point-of-care commitment reminders, point-of-care Choosing Wisely patient education handouts, and weekly emails with decision support resources. |
- Composite rates of ordering 3 potentially low-value services in primary care visits by adult patients [ Time Frame: Within 10 months of receiving the intervention ]Composite rates of ordering lumbar spine imaging tests in visits for low back pain, ordering antibiotics in visits for acute sinusitis, and ordering head imaging tests in visits for headaches.
- Composite rates of ordering potential substitute services for 3 potentially low-value services in primary care visits by adult patients [ Time Frame: Within 10 months of receiving the intervention ]Composite rates of ordering potential substitute services for lumbar spine imaging tests in visits for low back pain, ordering antibiotics in visits for acute sinusitis, and ordering head imaging tests in visits for headaches.

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | 21 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Primary care clinicians in 6 primary care (family medicine and internal medicine) clinics within the IHA organization of Ann Arbor, Michigan
Exclusion Criteria:
- None

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02247050
United States, Michigan | |
IHA Ann Arbor Family Medicine | |
Ann Arbor, Michigan, United States, 48103 | |
IHA Family Medicine - Arbor Park | |
Ann Arbor, Michigan, United States, 48105 | |
IHA Internal Medicine - Domino's Farms | |
Ann Arbor, Michigan, United States, 48105 | |
IHA Brighton Family Care | |
Brighton, Michigan, United States, 48114 | |
IHA Internal Medicine - Cherry Hill | |
Canton, Michigan, United States, 48187 | |
IHA Reichert Internal Medicine at Towsley | |
Ypsilanti, Michigan, United States, 48197 |
Principal Investigator: | Jeffrey T. Kullgren, MD, MS, MPH | University of Michigan |
Responsible Party: | Jeffrey T. Kullgren, Assistant Professor, University of Michigan |
ClinicalTrials.gov Identifier: | NCT02247050 |
Other Study ID Numbers: |
HUM00087820 71475 ( Other Grant/Funding Number: Robert Wood Johnson Foundation ) |
First Posted: | September 23, 2014 Key Record Dates |
Last Update Posted: | May 6, 2016 |
Last Verified: | May 2016 |
Costs and Cost Analysis Professional Practice Attitude of Health Personnel Health Knowledge, Attitudes, and Practice Decision Making Practice Guidelines as Topic Physician-Patient Relations Physician's Role Health Care Quality of Health Care Quality Assurance Physicians, Primary Care Evidence-Based Medicine Evidence-Based Practice Decision Support Systems, Clinical |
Reminder Systems Judgment Cognition Patient Care Health Services Misuse Unnecessary Procedures Prescribing Patterns, Physician Inappropriate Prescribing Over Prescribing Low Back Pain Sinusitis Infections, Upper Respiratory Generalized Headache Imaging, Diagnostic Antibiotics |