Reducing Potentially Inappropriate Medication Prescribing for Older Patients: Enhancing Quality of Provider Practices for Older Adults in the Emergency Department (EQUIPPED)
概览
- 阶段
- 不适用
- 干预措施
- EQUIPPED with Active Feedback
- 疾病 / 适应症
- Aging
- 发起方
- VA Office of Research and Development
- 入组人数
- 74
- 试验地点
- 4
- 主要终点
- Percentage of PIMs Prescribed
- 状态
- 已完成
- 最后更新
- 2个月前
概览
简要总结
This research is being conducted to learn which implementation strategy of EQUIPPED is most effective to improve prescribing practices of ED providers toward older Veterans and determine the factors influencing implementation of this program to reduce the prescribing of PIMs to older adults upon discharge from the ED. The study has three research aims. The procedures for these research aims are described below:
- Aim 1 - Examining the Impact of Passive Provider Feedback vs. Active Provider Feedback Through a Randomized Trial
- Aim 2 - Determination of Factors Affecting Organizational Adoption of EQUIPPED
- Aim 3 - Micro-Costing the Active and Passive Feedback Versions of the EQUIPPED Intervention
详细描述
Enhancing Quality of Prescribing Practices for Older Adults Discharged from the Emergency Department (EQUIPPED is a multi-component program to reduce the prescribing of potentially inappropriate medications (PIMs) to older adults upon discharge from the Emergency Department (ED). It has three core components: 1) provider education, 2) Electronic Health Record (EHR)-based clinical decision support (CDS) including pharmacy quick order sets to facilitate provider order entry, and 3) provider audit and feedback with peer benchmarking. In order to inform a Veterans Affairs (VA) system-wide approach to improve prescribing safety for older Veterans, the investigators will conduct a study to determine best practices for influencing provider prescribing behavior in order to decrease PIMs prescribed for older Veterans at the time of ED discharge. The overall goal of this project is to determine which EQUIPPED implementation strategy (active or passive feedback) is most effective to reduce prescribing of PIMs for older Veterans discharged from the ED.
研究者
入排标准
入选标准
- •Prescribers at VA Medical Centers that are implementing EQUIPPED
- •Members of the EQUIPPED implementation team at enrolled sites
排除标准
- •Providers at VA Medical Centers that are not part of the upcoming EQUIPPED implementation trial.
研究组 & 干预措施
Active Feedback
EQUIPPED with active provider feedback, implementing one-to-one (1:1) in-person academic detailing from a professional colleague that includes in-person audit, feedback, and peer benchmarking and provide on-site expertise.
干预措施: EQUIPPED with Active Feedback
Passive Feedback
EQUIPPED with passive provider feedback, implementing monthly provider feedback via an electronic dashboard with audit, feedback and peer benchmarking.
干预措施: EQUIPPED with Passive Feedback
结局指标
主要结局
Percentage of PIMs Prescribed
时间窗: 12-Months Post Implementation of EQUIPPED
Percentage of prescriptions that are PIMS (potentially inappropriate medications) as defined according to the Beers criteria prescribed to adults aged 65 and older and discharged from the ED.
次要结局
- Micro-Costing the Active and Passive Feedback Versions of the EQUIPPED Intervention(12-Months Post Implementation of EQUIPPED)
- Social Cognitive Theory Survey - Perceived Control Domain(12-Months After the Delivery of the First EQUIPPED Report)