- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT01034761
Using Clinical Alerts to Decrease Inappropriate Medication Prescribing
Using Clinical Alerts in a Computerized Provider Order Entry System to Decrease Inappropriate Medication Prescribing Among Hospitalized Elders
Introduction:
The Beers list identifies medications that should be avoided in persons 65 years or older because they are ineffective, pose an unnecessarily high risk, or a safer alternative is available. In a recent study, we found a high rate of prescribing of Beers list medications to hospitalized patients. At Baystate, 41% of medical patients received at least one Beers list drug classified as "high severity," meaning it carried a high risk for an adverse drug reaction, while 5% received 3 or more. Some Beers drugs have been associated with delirium and falls. When compared to Baystate patients who did not receive a high severity medication, those who did had an increased risk of mortality (7.8% vs. 5.2%), longer length of stay (5.5 days vs. 3.9 days) and higher costs ($11,240 vs. 6243).
Specific Aims:
- Quantify the impact of synchronous electronic alerts on physician prescribing of high-severity Beers' list drugs to hospitalized patients over the age of 65 years.
- Compare physician reactions to each drug-specific alert
Project Description:
We will develop a series of clinical alerts in CIS, Baystate's computerized provider order entry system, to reduce the use of potentially inappropriate medications among hospitalized elders. We will randomize providers to electronic alerts or usual care. Whenever a provider randomized to alerts attempts to place an order for a high-risk medication on the Beers list and the intended recipient is over 65 years of age, a synchronous alert (i.e. a "pop-up") will inform the physician about the risks associated with the medication and will propose safer alternatives.
We will collect data on physician ordering and patient outcomes comparing the number of Beers list prescriptions from providers receiving electronic alerts to those not receiving alerts. Our anticipated outcome is a decrease in inappropriate prescribing during the period when the electronic alerts are activated. Other potential outcomes include decrease in length of stay and a decrease in falls.
Descripción general del estudio
Tipo de estudio
Inscripción (Actual)
Fase
- No aplica
Contactos y Ubicaciones
Ubicaciones de estudio
-
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Massachusetts
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Springfield, Massachusetts, Estados Unidos, 01199
- Baystate Medical Center
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-
Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
- Hospitalized patients with Age > 65
Exclusion Criteria:
- None
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Prevención
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Único
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
---|---|
Sin intervención: Cuidado usual
|
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Experimental: Pop-up alerts
Providers will receive pop-up alerts in the electronic medical record when prescribing one of the specified medications from the Beers list.
|
Pop-up alert in the electronic medical record whenever the provider enters an order for a specified high risk medication from the Beers list.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Periodo de tiempo |
---|---|
The percentage of elderly patients who receive a specified high-risk medication from the Beer's list.
Periodo de tiempo: Earlier of hospital stay or end of study
|
Earlier of hospital stay or end of study
|
Medidas de resultado secundarias
Medida de resultado |
Periodo de tiempo |
---|---|
The average number of specified high risk medications prescribed per patient.
Periodo de tiempo: Earlier of hospital stay or end of study
|
Earlier of hospital stay or end of study
|
Restraint use
Periodo de tiempo: Earlier of hospital stay or end of study
|
Earlier of hospital stay or end of study
|
Falls
Periodo de tiempo: Earlier of hospital stay or end of study
|
Earlier of hospital stay or end of study
|
Length of stay
Periodo de tiempo: Earlier of hospital stay or end of study
|
Earlier of hospital stay or end of study
|
Total Cost
Periodo de tiempo: Earlier of hospital stay or end of study
|
Earlier of hospital stay or end of study
|
Discharge status
Periodo de tiempo: 6 months
|
6 months
|
Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Linda J Canty, MD, Baystate Medical Center
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Estimar)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Otros números de identificación del estudio
- 132454
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .
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