View article

There is uncertainty about the effectiveness of oral fluid restriction in patients with acute heart failure treated with intravenous loop diuretics, due to a lack of high-quality evidence from randomised controlled trials (RCTs). RCTs of non-pharmacological therapies are challenging and costly to undertake in the acute setting using conventional approaches. We sought to investigate the feasibility of conducting a pragmatic RCT that was integrated into the electronic health record (EHR), in the setting of acute unplanned care. Our primary aim was to determine the feasibility of using an automated, interruptive alert to invite clinicians to enrol patients into an RCT of fluid restriction in patients presenting with fluid overload.

THIRST Alert was a single-centre parallel group, open-label, randomised controlled trial conducted to pilot a novel and efficient approach to trial conduct in a hospital setting. Patient …