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Trial registered on ANZCTR
Registration number
ACTRN12617000224325
Ethics application status
Approved
Date submitted
8/02/2017
Date registered
10/02/2017
Date last updated
10/02/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Droperidol, Ondansetron, Placebo Antiemetic Trial for adult Emergency Department patients with nausea. (DOPAT)
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Scientific title
Droperidol and Ondansetron compared with Placebo: a randomized controlled Antiemetic Trial of adult patients with nausea in the Emergency Department. (DOPAT)
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Secondary ID [1]
291120
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Nil known
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Universal Trial Number (UTN)
U1111-1192-6351
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Trial acronym
DOPAT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Nausea and vomiting
301951
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Condition category
Condition code
Oral and Gastrointestinal
301602
301602
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Arm D: Droperidol 1.25 mg intravenously, one dose only
Arm O: Ondansetron 8 mg intravenously, one dose only
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Intervention code [1]
297105
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Treatment: Drugs
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Comparator / control treatment
Arm P: 0.9% normal saline placebo
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Proportion of participants with a reduction in nausea of 5 mm or greater on a visual analog scale.
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Assessment method [1]
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Timepoint [1]
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30 minutes post-treatment
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Secondary outcome [1]
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Comparison of mean change in nausea between groups on a Visual Analog Scale.
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Assessment method [1]
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Timepoint [1]
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30 minutes post-treatment
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Secondary outcome [2]
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Comparison of patient centered outcome between groups, as response to the question “The medicine I received had the desired effect for me”, Yes or No.
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Assessment method [2]
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Timepoint [2]
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30 minutes post-treatment.
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Secondary outcome [3]
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Comparison between groups of use of additional antiemetic medication, with drug and dose to be recorded on the study case report form..
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Assessment method [3]
331402
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Timepoint [3]
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30 minutes post-treatment
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Secondary outcome [4]
331403
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Description of adverse events for all groups. Absence or presence (mild/moderate/severe) of headache or dizziness will be specifically noted. Agitation or sedation will be rated on the Richmond Agitation-Sedation Scale. Any other adverse events will be noted as free text.
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Assessment method [4]
331403
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Timepoint [4]
331403
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From 30 minutes post-treatment to conclusion of ED episode of care.
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Eligibility
Key inclusion criteria
Emergency Department patients aged 18 years or more, with nausea and/or vomiting as a primary or secondary complaint (any underlying cause).
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Known allergy to ondansetron or droperidol
* Use of an agent with known antiemetic properties in the previous 4 hours, either prior to ED arrival, or earlier in the current ED episode of care. Includes: ondansetron, droperidol, metoclopramide, promethazine, chlorpromazine, prochlorperazine and any steroid medication.
* Patients considered too unwell to consent or participate for any reason, including cardiovascular instability, hepatic failure, renal failure or altered mental state.
* Contraindication to the administration of normal saline infusion during the study period (e.g. left ventricular failure, chronic renal failure)
* Patients with Parkinson’s disease or restless leg syndrome.
* Patients taking a dopamine antagonist for any reason. Includes: amisulpride, chlorpromazine, clopenthixol or flupenthixol, domperidone, haloperidol, paliperidone, quetiapine, risperidone, thioridazine.
* Patients with cognitive impairment or language barrier which compromises understanding of the outcome measurements.
* Patients with motion related nausea or vertigo, which have other specific recommended treatments, albeit with little supporting evidence
* Pregnant or breast feeding women; ondansetron is category B and droperidol category C, with both being excreted to breast milk
* Chemotherapy or radiotherapy induced nausea and vomiting (CINV or RINV), which have other specific recommended antiemetic treatments
* Inability to comply with an instruction to not drive or operate machinery for a minimum of 4 hours post-dosage; droperidol may impair these functions for a period of time, although 1.25 mg IV is a relatively small dose compared with dosages used for other indications
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomization by Pharmacy Department, Clinical Trials. This group is independent to all clinical units, will perform the randomization and will provide the syringes of de-identified study drugs..
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomization.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Prior study support that ondansetron leads to symptom improvement (as defined for this study) in 83% of patients, compared with 63% for plabebo. A similar figure for droperidol was not known, but previous research suggests droperidol is at least as effective as ondansetron.. Based on replication of this, a sample of 112 per group was required to demonstrate difference between ondansetron and/or droperidol versus placebo. Aim to recruit 126 per group. Comparisons will primary utilize the chi square (or Fisher's Exact) test, and a Number Needed to Treat will be calculated. There was insufficient information to consider powering the study to compare ondansetron with droperidol.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
14/03/2017
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Actual
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Date of last participant enrolment
Anticipated
14/06/2017
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Actual
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Date of last data collection
Anticipated
14/06/2017
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Actual
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Sample size
Target
378
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
7444
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Dandenong Hospital - Dandenong
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Recruitment hospital [2]
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Monash Medical Centre - Clayton campus - Clayton
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Recruitment hospital [3]
7446
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Casey Hospital - Berwick
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Recruitment postcode(s) [1]
15264
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3175 - Dandenong
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Recruitment postcode(s) [2]
15265
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3168 - Clayton
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Recruitment postcode(s) [3]
15266
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3806 - Berwick
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Monash Emergency Research Fund
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Address [1]
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c/- Emergency Department
Dandenong Hospital
David Street
Dandenong, Vic, 3175.
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Country [1]
295560
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Australia
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Funding source category [2]
295562
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Charities/Societies/Foundations
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Name [2]
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Morson Taylor Foundation
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Address [2]
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c/- Australasian College for Emergency Medicine
34 Jeffcott Street
West Melbourne, Vic, 3003
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Country [2]
295562
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Australia
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Primary sponsor type
Individual
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Name
Robert Meek
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Address
c/- Emergency Department
Dandenong Hospital
David Street
Dandenong, Vic, 3175
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Andis Graudins
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Address [1]
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c/- Emergency Department
Dandenong Hospital
David Street
Dandenong, Vic, 3175
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Country [1]
294380
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Australia
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Secondary sponsor category [2]
294385
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Individual
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Name [2]
294385
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Michaela Mee
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Address [2]
294385
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c/- Emergency Department
Monash Medical Centre
Clayton Road
Clayton, Vic, 3168
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Country [2]
294385
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Australia
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Secondary sponsor category [3]
294386
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Individual
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Name [3]
294386
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Diana Egerton-Warburton
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Address [3]
294386
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c/- Emergency Department
Monash Medical Centre
Clayton Road
Clayton, Vic, 3168
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Country [3]
294386
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Australia
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Secondary sponsor category [4]
294387
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Individual
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Name [4]
294387
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Alastair Meyer
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Address [4]
294387
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c/- Emergency Department
Casey Hospital
Kangan Drive
Berwick, Vic, 3806
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Country [4]
294387
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Australia
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Secondary sponsor category [5]
294388
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Individual
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Name [5]
294388
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Pourya Pouryaha
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Address [5]
294388
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c/- Emergency Department
Casey Hospital
Kangan Drive
Berwick, Vic, 3806
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Country [5]
294388
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296880
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Monash Human Research Ethics Committee
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Ethics committee address [1]
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Research Directorate Monash Medical Centre Clayton Road Clayton, Vic, 3168
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Ethics committee country [1]
296880
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Australia
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Date submitted for ethics approval [1]
296880
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01/12/2016
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Approval date [1]
296880
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05/12/2016
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Ethics approval number [1]
296880
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RES-16-0000-574A
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Summary
Brief summary
Study Purpose: Previous ED-based antiemetic research has failed to show a benefit of antiemetic drugs over placebo, with the possible exception of droperidol 1.25 mg IV. This has led to doubts about the value of ED antiemetic drug use, or further ED-based antiemetic research. Recent literature has suggested that the primary outcome measure in the ED-based placebo controlled RCTs to date (comparison of mean VAS change between groups) may not have been sensitive enough to detect true differences. Hence, for this study, an alternate primary outcome measure of VAS reduction in excess of 5 mm is being used, as this cut-off level has been shown to equate with symptom improvement. Study findings should then clarify whether or not antiemetic drugs do have value for ED patients, and may guide future research directions regarding antiemetic drug use in the ED.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Robert Meek
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Address
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Emergency Department
Dandenong Hospital
David Street
Dandenong, Vic, 3175
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Country
72318
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Australia
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Phone
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+61 3 9554 8475
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Fax
72318
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+61 3 9554 8453
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Email
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[email protected]
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Contact person for public queries
Name
72319
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Robert Meek
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Address
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Emergency Department
Dandenong Hospital
David Street
Dandenong, Vic, 3175
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Country
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Australia
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Phone
72319
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+61 3 9554 8475
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Fax
72319
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+61 3 9554 8453
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Email
72319
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[email protected]
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Contact person for scientific queries
Name
72320
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Robert Meek
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Address
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Emergency Department
Dandenong Hospital
David Street
Dandenong, Vic, 3175
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Country
72320
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Australia
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Phone
72320
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+61 3 9554 8475
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Fax
72320
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+61 3 9554 8453
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Email
72320
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
In adults in the emergency department with nausea, neither droperidol nor ondansetron improved symptoms.
2019
https://dx.doi.org/10.7326/ACPJ201903190-030
Embase
Randomized Placebo-controlled Trial of Droperidol and Ondansetron for Adult Emergency Department Patients With Nausea.
2019
https://dx.doi.org/10.1111/acem.13650
N.B. These documents automatically identified may not have been verified by the study sponsor.
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