THIRST Alert Trial
Research type
Research Study
Full title
THIRST Alert Trial – a Randomised Controlled Trial within the electronic Health record of an Interruptive alert displaying a fluid Restriction Suggestion in patients with the treatable Trait of congestion
IRAS ID
313551
Contact name
Pushpsen Joshi
Contact email
Sponsor organisation
UCL
Clinicaltrials.gov Identifier
Clinicaltrials.gov Identifier
UCL Data protection number, Z6364106/2022/08/35
Duration of Study in the UK
0 years, 3 months, 30 days
Research summary
The aim of the study is to determine whether an alert embedded within the electronic health record (EHR) causes clinicians to enrol patients into a randomised trial testing whether fluid intake improves outcomes in patients admitted to hospital with fluid overload. One of the main causes of fluid overload is heart failure. A lack of strong evidence to support the safety or effectiveness of oral fluid restriction in the acute setting causes significant variation in clinical practice. Patients are told to restrict fluid or not, based primarily on preference of the treating clinician rather than evidence from research.
THIRST Alert is a pragmatic randomised controlled trial (RCT) embedded in the EHR. Pragmatic is defined as examining whether interventions work as part of routine NHS care rather than within a formal research setting.
The intervention triggering fluid restriction is a EHR-based alert to the treating clinician when they prescribe an intravenous medication that used for treating fluid overload. The clinician will be asked to consider enrolling the patient only if they deem there is uncertainty about whether fluid restriction will cause benefit or harm. If appropriate, the patient would then be randomised to receiving an instruction of oral fluid restriction of 1 litre per day or no restriction. The study will record the number of patients recruited from routine care, the effect of the alert on clinician behaviour and patients’ subsequent oral fluid intake. The alert only goes to the clinician with no additional burden on patients. The trial starts on admission and finishes on discharge from the study site and will be supported by the UCLH NIHR Biomedical Research Centre and UCL.REC name
London - Riverside Research Ethics Committee
REC reference
22/LO/0889
Date of REC Opinion
18 Jan 2023
REC opinion
Further Information Favourable Opinion