Development of the Medicines Optimisation Assessment Tool (MOAT)
Development of the Medicines Optimisation Assessment Tool (MOAT) - Targeting Hospital Pharmacists' Input to Reduce Risks and Improve Patient Outcomes
調査の概要
状態
詳細な説明
The purpose of this study is to develop a prediction-tool, the Medicines Optimisation Assessment Tool (MOAT), to assist hospital pharmacists identify patients at highest risk of preventable medication related problems (MRPs).
The MOAT will be developed following recommendations of the PROGnosis RESearch Strategy (PROGRESS) partnership. A prospective cohort study of 1,500 patients will be used to develop the MOAT from the medical wards of two UK hospitals. Data will be collected on prognostic factors (selected based on a review of published literature and expert opinion) for each patient, together with details of MRPs that occur. All MRPs will be reviewed by an expert panel who will grade for severity and preventability using recognised criteria. Multivariable logistic regression models will be used to determine the relationship between potential risk factors such as polypharmacy, renal impairment, and the use of 'high risk' medicines, and the study outcome of preventable medication related problems that are at least moderate in severity. Bootstrapping will be used to adjust the MOAT for optimism, and predictive performance will be assessed using calibration and discrimination. A simplified scoring system will also be developed, which will be assessed for sensitivity and specificity.
The intention of this research is to develop a prediction-tool (the MOAT), which has the potential to be adopted widely into clinical practice. If the initial research is successful in producing a prediction-tool with good predictive performance further research will be carried out to assess how feasible it would be to use the MOAT in practice, the potential efficiency savings, and an assessment of clinical risk to patients through use of the MOAT.
研究の種類
入学 (実際)
連絡先と場所
研究場所
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Bedfordshire
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Luton、Bedfordshire、イギリス、LU40DZ
- Luton and Dunstable University Hospital
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- subject admitted to the Medical Division (General, Emergency, and Elderly Medicine) at the study sites
Exclusion Criteria:
- subject admitted for investigation-only
- subject not prescribed medication
- subject both admitted and subsequently discharged outside of core pharmacy working hours
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
- 観測モデル：コホート
- 時間の展望：見込みのある
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 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Number of MRPs experienced by study participants
時間枠：Through study completion (discharge from hospital), an average of 6 days
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The outcome measure (i.e.
all MRPs) will be graded for severity and preventability, then multivariate analysis such as logistic regression models will be used to determine the relationship between predictors (prognostic factors) and the outcome (MRPs which are at least moderate in severity and preventable).
The objective will be to find the best combinations of predictors that are highly sensitive for detecting the outcome measure while achieving the maximum possible specificity.
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Through study completion (discharge from hospital), an average of 6 days
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Feasibility of using the MOAT (content validity and ease of use)
時間枠：18 months
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Content validity will be assessed to ensure that clinicians consider the items in the MOAT to be clinically sensible, no obvious items are missing, the method of grouping the individual predictors is reasonable, and the items seem appropriate for the purpose of the tool.
Ease of use depends on the length of time needed to apply the tool and the simplicity of interpretation.
A consensus development technique will be used to generate consensus on content validity and simplicity of interpretation.
Time to apply the MOAT will be assessed by observation.
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18 months
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Potential efficiency savings
時間枠：18 months
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The impact of the MOAT in terms of potential workload for pharmacists will be informed by the number of patients who screen positive (from internal validation).
This will indicate the proportion of patients who would be expected to require review by a pharmacist, i.e. the total number that pharmacists would need to see to identify those at highest risk of MRPs.
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18 months
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Potential clinical risk to patients through use of the MOAT
時間枠：18 months
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Patients who experience an MRP but would be excluded from pharmacist review by the MOAT (i.e.
false negatives) will be reviewed in detail to identify the potential clinical risk (i.e.
severity of missed events).
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18 months
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協力者と研究者
捜査官
- 主任研究者：Cathy Geeson、University College, London
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 (実際)
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 (実際)
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
本研究に関する用語
その他の研究ID番号
- 15/0525
- CDRF-2014-05-033 (その他の助成金/資金番号：National Institute for Health Research (NIHR))
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
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