- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05146388
Working With Doctors and Pharmacists to Help Parents Give Children's Liquid Medicines Safely
Leveraging the EHR to Promote Pharmacy Adoption of Dosing Best Practices and Reduce Parent Errors in Administering Pediatric Liquid Medications: A Health Literacy-Informed Approach
The study objective is to assess the impact of an automated electronic health record (EHR)-based intervention that leverages e-prescriptions to support pharmacist adherence to recommended dispensing practices, with the goal of reducing parent dosing errors.
Specifically, the study aims are to: 1) Examine the efficacy of the EHR-based intervention in improving pharmacy dispensing practices, including a) adherence to mL-only dosing and b) provision of optimal dosing tools; 2) Examine the efficacy of the EHR-based intervention in reducing parent dosing errors. The study will also explore whether implementation of the EHR-based intervention will reduce disparities in dosing errors by parent health literacy and LEP, and explore the efficacy of the EHR-based intervention in reducing ADEs.
A pre-/post-implementation study will be performed with English- and Spanish-speaking parents of children prescribed oral liquid medications in the pediatric emergency room, outpatient general pediatric clinic, and pediatric subspecialty clinics of 2 New York City hospital systems (NYU Langone Health - Brooklyn and NYC Health+Hospitals - Bellevue Hospital). Prior to implementation, e-Rx's will be generated by the EHR in the usual fashion; after implementation, e-Rx's will be generated by the EHR with instructions to the dispensing pharmacy to: 1) keep the dosing instructions in mL-only, and 2) dispense a specific dosing tool based on the amount prescribed.
The proposed project is consistent with a growing national focus on promoting the adoption of evidence-based strategies to improve disease management that address the needs of those with low health literacy and LEP from groups like the Joint Commission and the AHRQ.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: H. Shonna Yin, MD, MS
- Phone Number: 212-562-2821
- Email: Hsiang.Yin@nyulangone.org
Study Contact Backup
- Name: Jennifer Melgar, MBS
- Phone Number: 212-562-2821
- Email: Jennifer.Melgar@nyulangone.org
Study Locations
-
-
New York
-
Brooklyn, New York, United States, 11220
- Recruiting
- NYU Langone Health - Brooklyn
-
Contact:
- Jennifer Melgar, MBS
- Email: Jennifer.Melgar@nyulangone.org
-
Contact:
- H. Shonna Yin, MD, MS
- Email: Hsiang.Yin@nyulangone.org
-
Principal Investigator:
- H. Shonna Yin, MD, MS
-
Brooklyn, New York, United States, 11220
- Recruiting
- Sunset Park Family Health Center at NYU Langone
-
Contact:
- Jennifer Melgar, MBS
- Email: Jennifer.Melgar@nyulangone.org
-
Contact:
- H. Shonna Yin, MD, MS
- Email: Hsiang.Yin@nyulangone.org
-
Principal Investigator:
- H. Shonna Yin, MD, MS
-
New York, New York, United States, 10016
- Not yet recruiting
- NYC Health + Hospitals / Bellevue
-
Contact:
- Jennifer Melgar, MBS
- Email: Jennifer.Melgar@nyulangone.org
-
Contact:
- H. Shonna Yin, MD, MS
- Email: Hsiang.Yin@nyulangone.org
-
Principal Investigator:
- H. Shonna Yin, MD, MS
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Caregiver/Child
- English or Spanish-speaking
- Parent or legal guardian of a child prescribed a liquid medicine in the NYU Langone Health - Brooklyn or Bellevue ED, general outpatient pediatric clinic, or specialty care clinics
- 18 years of age or older
- Child ≤8y discharged home with a Rx for ≥1 daily liquid medication dose ≤10mL, for use as a chronic or short course (≤14 days) medication
- Primary person who will administer child's medications
- Access to a smartphone that can take photos and send/receive text messages
- Willingness and ability to participate
Pharmacy staff
1. Works at a pharmacy that dispensed index medicine to one of our study participants.
Exclusion Criteria:
Caregiver/Child
- Does not have a working phone number
- Not able to return for in-person follow-up visit
- Was told to stop medication by provider after doctor/ED visit
- Parent no longer having index medication bottle
- Uncorrected hearing impairment
- Self-reported poor visual acuity
Pharmacy staff
1. Staff with no responsibility in determining unit of measure to include on Rx's or type/capacity of the dosing tool to dispense for pediatric oral liquid medications.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: Pre-Implementation - Usual Care
In pre-implementation phase, patient e-Rxs will be generated by the EHR in the usual fashion.
|
|
Experimental: Post-Implementation - EHR-Based Approach
|
The intervention will be built directly into the EHR.
E-prescriptions will be generated with pharmacy instructions for all prescription medications.
The intervention will impart: 1) inclusion with e-Rx request for pharmacy to keep metric-only (mL-only) dosing on Rx label and 2) inclusion of guidance on the e-Rx requesting that the pharmacy give an optimal tool based on an algorithm.
Algorithm for dosing tool recommendation: 1) for a prescribed dose of <= 1mL, optimal tool is 1 mL syringe, 2) for >1 mL to 5 mL, use a 5 mL syringe, 3) for >5mL to 10mL, use 10 mL syringe.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Caregiver Dosing Error
Time Frame: Within 8 weeks of index visit (Visit 2)
|
Dosing error will be defined as >20% deviation from the prescribed dose
|
Within 8 weeks of index visit (Visit 2)
|
Caregiver Large Dosing Error
Time Frame: Within 8 weeks of index visit (Visit 2)
|
Large dosing error will be defined as >40% deviation from the prescribed dose
|
Within 8 weeks of index visit (Visit 2)
|
Pharmacy Use of mL-only on Rx Label
Time Frame: Within 4 weeks of index visit (Visit 1)
|
Within 4 weeks of index visit (Visit 1)
|
|
Pharmacy Provision of Optimal Dosing Tool
Time Frame: Within 4 weeks of index visit (Visit 1)
|
Within 4 weeks of index visit (Visit 1)
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: H. Shonna Yin, MD, MS, NYU Langone Health
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- 21-00972
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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