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

    uclh.randd@nhs.net

  • Sponsor organisation

    UCL

  • Clinicaltrials.gov Identifier

    NCT05869656

  • 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