Effectiveness of an EHR Interface to Reduce Dosage of Hydroxychloroquine
Effectiveness of an EHR Interface to Reduce Dosage of Hydroxychloroquine
Hydroxychloroquine (HCQ) is a disease-modifying, anti-rheumatic drug that regulates immune
 system activity and is typically prescribed to treat rheumatoid arthritis and systemic lupus
 erythematosus, as well as other immune conditions. Although generally well tolerated, study
 data have demonstrated that long-term use of HCQ may lead to irreversible and potentially
 vision-threatening retinal toxicity. The American Academy of Ophthalmology (AAO) issued
 guidelines in 2011, and again in 2016 that recommended dosing of HCQ be based on an
 individual's body weight, and also outlined how and when to screen for retinal toxicity.
 While clinicians have been aware of the potential side effects of HCQ for decades, studies
 have shown that many patients continue to receive higher than recommended doses.

 The goal of this study is to conduct a pragmatic trial to assess the utility of a new
 e-prescribing (eRX) interface for prescriptions of hydroxychloroquine (HCQ). The
 investigators will measure the effectiveness of the system in reducing the number of
 individuals prescribed HCQ over current guidelines by randomizing clinicians to the new
 interface. Ideally, the eRX interface will result in a lower number of potential adverse
 events (i.e. retinal toxicity) associated with high-dose, long-term use of HCQ.
Inclusion Criteria:

 -  All providers that prescribed hydroxychloroquine in the year previous to the
 intervention start date in rheumatology and dermatology clinics

 Exclusion Criteria:

 -  Inactive providers in rheumatology and dermatology clinics