Using Informatics to Enhance Care of Older Emergency Department Patients
Computer-Assisted Decision Support to Increase the Safety of Prescribing to Older Emergency Department Patients
The subjects in this study are physicians working in the Wishard Emergency Department. The purpose of this study is to measure the extent to which information technology (i.e.-computers) improves emergency department care. The objective of our study is to evaluate the use of informatics in the emergency department and specifically to determine if computer reminder systems: 1) reduce the number of unsafe medications prescribed to older adults, 2) assist in more safely dosing of medications to adults of all ages, and 3) increase influenza immunization of eligible older patients in the emergency department.
Interventions: The interventions in this study are computer reminders. When releasing patients from the emergency department, physicians currently write all release orders, including prescriptions, on a computer order entry system that is linked to the Regenstrief Medical Record System. The computerized order entry system will be programmed so that physicians randomized (randomly placed) into the intervention group, the group that will receive the intervention, they will receive one of three types of reminders:
- The medication prescribed is generally considered unsafe for use in older patients. The reminder will then list appropriate alternatives for this medication.
- The dose of the prescribed medication is excessive and should be adjusted for the patient's creatinine clearance (or kidney function).
- This patient may be eligible for influenza vaccination.
The physician will then choose to order or disregard the recommendation. The computer system will automatically record what the physician selected to do. The general outcome of interest is the extent to which the electronic reminders successfully improved physician practice in the emergency department setting. This outcome will be compared to physicians who were randomized to the group that did not receive the reminders (the control group).
調査の概要
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Indiana
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Indianapolis、Indiana、アメリカ、46202
- Wishard Memorial Hospital
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参加基準
適格基準
就学可能な年齢
- 子
- 大人
- 高齢者
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- The subjects of this study will be physician providers and residents and medical students practicing under the supervision of a faculty emergency physician. Specific study subjects will include emergency medicine faculty physicians; emergency medicine and internal medicine residents; emergency medicine, surgery, and internal medicine interns; and medical students taking care of patients in our emergency department.
Exclusion Criteria:
- We will not include the members of the research team in this study.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:階乗代入
- マスキング:4倍
武器と介入
参加者グループ / アーム |
介入・治療 |
---|---|
介入なし:1
|
|
実験的:2
Electronic warnings when providers prescribe a potentially inappropriate medication or an excessively dosed medication (based on estimated creatinine clearance)
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Electronic warnings when providers prescribe a potentially inappropriate medication or an excessively dosed medication (based on estimated creatinine clearance)
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
時間枠 |
---|---|
Proportion of older ED patients who receive a potentially inappropriate medication
時間枠:During discharge home from the ED
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During discharge home from the ED
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二次結果の測定
結果測定 |
時間枠 |
---|---|
Proportion of ED patients who receive an excessive dose of a medication that requires dosage adjustment for renal insufficiency
時間枠:During discharge home from the ED
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During discharge home from the ED
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協力者と研究者
捜査官
- 主任研究者:Kevin M. Terrell, DO, MS、Indiana University School of Medicine
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
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