Conclusions
death, Cancer
CANCER
In this single-center, unblinded, EHR-nested RCT, we found insufficient evidence for EHR-nested reminders to increase the achievement of therapeutic serum lithium concentration at 18 months after enrollment. However, the number of monitoring increased with a relatively simple and inexpensive intervention. The EHR-based reminders may be useful to improve quality of care for patients on lithium maintenance therapy, and they have potential to be applied to other problems.The authors thank all staff at the Department of Psychiatry of Toyooka Hospital for their support in the trial. They also thank Dr Masakatsu Hattori and Mr Takahiko Tsujimoto (Real World Data Co Ltd) for the development, operation, and maintenance of the EHR-nested system. This study was supported by JSPS KAKENHI (TAF, grant JP17H04122); (TS, grant JP19K10509). None of the study funders had any role in the study design, collection, management, analysis, interpretation of data, writing of the report, or decision to submit the report for publication.Authors' Contributions: TS, MA, and TAF had full access to all the data in the study and take the responsibility for the integrity of the data and the accuracy of the data analysis. The first authors (TS and MA) contributed equally. TS, MA, K Kawakami, and TAF conceived the study. TS, MA, HK, ST, K Kawakami, and TAF designed the study. MA, HK, T Miki, YS, TA, K Katsuragi, TK, SU, T Miyagi, and SN collected the data. TS, MA, ST, and TAF contributed to data analysis and interpretation. TS and ST performed statistical analyses. TS, MA, and TAF wrote the first draft of this manuscript. All authors critically reviewed and approved the final version of the manuscript. TS and TAF obtained funding. K Kawakami and TAF supervised this study.Conflicts of Interest: ST has received lecture fees from Bayer Yakuhin, Amgen Astellas BioPharma KK, and the Research Institute of Healthcare Data Science. He has received consultation fees and outsourcing fees from Daiichi Sankyo Co Ltd, Boehringer Ingelheim, Satt, and the Public Health Research Foundation. He has received research grants from the Japan Agency for Medical Research and Development, the Japanese Ministry of Health Labor and Welfare, the Japanese Ministry of Education, Science, and Technology, and Novo Nordisk. He has been engaged in a research project with the Japan Agency for Medical Research and Development. K Kawakami has received research funds from Eisai Co, Ltd; Kyowa Kirin Co, Ltd; Sumitomo Dainippon Pharma Co, Ltd; Pfizer Inc; Stella Pharma Corporation; CMIC Co, Ltd; Suntory Beverage & Food Ltd; Mitsubishi Corporation, and Real World Data Co, Ltd; consulting fees from LEBER Inc; JMDC Inc; Shin Nippon Biomedical Laboratories Ltd; Kaken Pharmaceutical Co, Ltd; Advanced Medical Care Inc; executive compensation from Cancer Intelligence Care Systems, Inc; honorarium from Mitsubishi Chemical Holdings Corporation, Mitsubishi Corporation, and Pharma Business Academy; and holds stock in Real World Data Co, Ltd. TAF has received lecture fees from Janssen, Meiji, Mitsubishi-Tanabe, MSD, and Pfizer. He has received research support from Mitsubishi Tanabe and Mochida. All other authors have reported that they have no relationships relevant to the contents of this article.Eligibility criteria.Reasons of death and unable to follow-up.CONSORT-eHEALTH checklist (V 1.6.1).