The Study in Outpatient Medicine Using Nudges to Improve Sleep
Key facts
- Who runs it
- University of Southern California
- Where
- Chicago, United StatesSee the site
- Trial code
- Status
- Active, not recruiting
- People taking part
- 444 people enrolled
- Started
- 20 Dec 2024
- Expected to end
- Jun 2027
- Type of study
- Interventional, 4 groupsOne group gets no study treatment, for comparison.
- Treatments tested
- Z-drug Default Quantity
- Redirection + Accountable Justification
- Record updated
- 26 June 2026
Who can take part
- Age
- 18 years and older
- Sex
- Women and men
- Healthy volunteers
- Cannot take part
The registry criteria, word for word
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Who can take part
- Outpatient primary care clinician at Northwestern Medicine
Who cannot take part
- Visit involves patient with ICD-10 F31.X diagnosis code (bipolar disorder) present in the last year or on active problem list
- Clinician participated in pilot study
- Clinician-investigator for this trial
Where in United States
- Northwestern MedicineChicago, United StatesNo longer taking part
About the trial
What the trial wants to find out
The goal of this clinical trial is to learn if electronic health record (EHR) nudges (changes to the EHR that do not restrict freedom of choice or alter incentives) can reduce Z-drug prescribing in primary care clinics for patients with insomnia. The main questions it aims to answer are:
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1. Can Z-drug prescribing be reduced by setting the dispense quantity default of new Z-drug orders in the EHR to 10 pills with 0 refills? 2. Can Z-drug prescribing be reduced by an EHR alert that suggests clinicians remove a Z-drug and/or add an evidence-based behavioral treatment for insomnia, followed by a request to justify their reasoning if the suggestion is not followed? 3. Does combining these two nudges reduce Z-drug prescribing?
Researchers will compare each nudge individually and in combination to an guideline education control group to see if each nudge (separately and in combination) can reduce Z-drug prescribing.
Clinician-participants will:
1. Complete an introductory educational module about treating insomnia and relevant EHR changes. 2. Complete their routine patient visits. 3. Either experience EHR changes when prescribing Z-drugs, including a Z-drug dispense quantity default of 10 pills for new orders, a prompt to remove or justify Z-drug orders, both, or neither.
The 4 groups in the trial
- ControlNo study treatment, for comparison
Clinicians randomized to this arm receive guideline education prior to the trial.
- Z-drug Default QuantityTreatment being tested
Clinicians randomized to this arm receive guideline education + 10 pill quantity defaults.
- Redirection + Accountable JustificationTreatment being tested
Clinicians randomized to this arm receive guideline education + alerts requiring justification of orders discordant with guidelines. Justifications are entered in the patient's medical record, and can be viewed by other clinicians.
- CombinedTreatment being tested
Clinicians randomized to this arm receive guideline education + 10 pill quantity defaults + alerts requiring justification of orders discordant with guidelines. Justifications are entered in the patient's medical record, and can be viewed by other clinicians
Treatment: Z-drug Default Quantity and Redirection + Accountable Justification
Data and sources
- Registry record
- Listed on ClinicalTrials.gov.
- Official title
- The Study in Outpatient Medicine Using Nudges to Improve Sleep: The SOMNUS Trial
- Publications
- Record updated
- 26 June 2026