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Trial registered on ANZCTR
Registration number
ACTRN12619001205123
Ethics application status
Approved
Date submitted
8/08/2019
Date registered
28/08/2019
Date last updated
17/11/2021
Date data sharing statement initially provided
28/08/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Droperidol vs Ondansetron in Nausea Treatment in the Emergency Department (DONuT)
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Scientific title
Therapeutic Management of Nausea in the Emergency Department: A randomised comparison of Droperidol and Ondansetron
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Secondary ID [1]
298702
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none
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Universal Trial Number (UTN)
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Trial acronym
DONuTED
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
nausea
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Condition category
Condition code
Oral and Gastrointestinal
312042
312042
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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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Emergency medicine
312520
312520
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0
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Other emergency care
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Droperidol 2.5mg intravenously. One dose only. Participants will be randomised into intervention or control group. Once the participant has been allocated to the intervention group, the treating physician will chart the intervention on the electronic medication chart and the intervention will be given by the treating nurse, which will be subsequently logged. Fidelity will be monitored by review of the electronic medication chart within the electronic medical record - which will document the time when the intervention was administered.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
Ondansetron 8mg intravenously. One dose only.
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Control group
Active
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Outcomes
Primary outcome [1]
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Proportion of participants with a change 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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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 [3]
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Timepoint [3]
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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)
Computer generated random numbers to allocate sequentially numbered, sealed/opaque envelopes, to treatment group 1 (ondansetron) or treatment group 2 (droperidol)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created in Microsoft Excel
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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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
Safety/efficacy
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Statistical methods / analysis
The measured difference on the visual analog scale between time of medication administration and 30 minutes later will be considered the nausea improvement score.
Power calculation (0.8) based on number of participants required to detect a 20% difference between the nausea improvement score for each of the two interventions. Although a previous study suggested no difference between the two medications, this was conducted using significantly lower dose of droperidol.
Comparison of the nausea improvement scores between both intervention groups will be done using the t-test.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/01/2020
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Actual
4/02/2020
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Date of last participant enrolment
Anticipated
1/10/2020
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Actual
18/08/2021
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Date of last data collection
Anticipated
1/10/2020
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Actual
18/08/2021
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Sample size
Target
120
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Accrual to date
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Final
180
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Port Macquarie Base Hospital - Port Macquarie
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Recruitment hospital [2]
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Kempsey District Hospital - Kempsey
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Recruitment postcode(s) [1]
27182
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2444 - Port Macquarie
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Recruitment postcode(s) [2]
27183
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2440 - Kempsey
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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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Port Macquarie Base Hospital
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Address [1]
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Wrights Road
Port Macquarie 2444 NSW
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
A/Prof Gabriel T Lau
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Address
Emergency Department
Port Macquarie Base Hospital
Wrights Road
Port Macquarie 2444 NSW
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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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Lachlan Philpott
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Address [1]
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UNSW Rural Clinical School
Port Macquarie Campus
26 Highfields Circuit
PORT MACQUARIE NSW 2444 AUSTRALIA
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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North Coast Human Research Ethics Committee
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Ethics committee address [1]
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PO Box 821 Murwillumbah NSW 2484
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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08/08/2019
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Approval date [1]
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11/10/2019
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Ethics approval number [1]
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2019/ETH12203
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Summary
Brief summary
Ondansetron is an anti-emetic drug that is commonly used in the emergency department to treat nausea and vomiting. Droperidol is an older anti-emetic medication where usage had fallen out of favour until recently, due to unfounded fears concerning QT prolongation. There is anecdotal evidence that IV droperidol is superior to ondansetron for treatment of nausea and vomiting. Although no difference was noted between the two drugs in a recent study, the dose of droperidol that was used was less that what would commonly be used in an emergency department setting. The question is if a higher dose of droperidol will likely demonstrate a difference.
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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 Gabriel T Lau
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Address
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Emergency Department
Port Macquarie Base Hospital
Wrights Road
Port Macquarie 2444 NSW
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Country
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Australia
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Phone
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+61 0466 140 339
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Gabriel T Lau
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Address
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Emergency Department
Port Macquarie Base Hospital
Wrights Road
Port Macquarie 2444 NSW
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Country
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Australia
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Phone
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+61 0466 140 339
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Gabriel T Lau
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Address
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Emergency Department
Port Macquarie Base Hospital
Wrights Road
Port Macquarie 2444 NSW
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Country
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Australia
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Phone
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+61 0466 140 339
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
All de-identified data collected during this trial
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When will data be available (start and end dates)?
Beginning 3 months and ending 5 years following main results publication
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Available to whom?
Case-by-case at discretion of the primary sponsor
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Available for what types of analyses?
Any purpose
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How or where can data be obtained?
Data will be provided by e-mail from principle investigator - contact
[email protected]
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
3002
Study protocol
[email protected]
3003
Statistical analysis plan
[email protected]
3004
Informed consent form
[email protected]
3005
Clinical study report
[email protected]
3006
Ethical approval
[email protected]
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
Droperidol versus ondansetron for nausea treatment within the emergency department.
2023
https://dx.doi.org/10.1111/1742-6723.14174
N.B. These documents automatically identified may not have been verified by the study sponsor.
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