Trial Outcomes & Findings for Achieving Medication Safety During Acute Kidney Injury (NCT NCT01134900)

NCT ID: NCT01134900

Last Updated: 2012-02-27

Results Overview

Our primary outcome measured the rate of AKI-related ADEs and pADEs. We defined pADEs as incidents with the potential for injury related to a drug, such as use of a non-steroidal anti-inflammatory drug for at least 24 hours, and ADEs as injuries resulting from the administration of a drug, such as a toxic vancomycin trough level or a bleed after administration of enoxaparin. We measured outcomes after completion of the inpatient encounter (either by death or discharge); pADEs or ADEs occurring after patient discharge were not included in the analysis.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

540 participants

Primary outcome timeframe

Until patient discharge (~2 week average)

Results posted on

2012-02-27

Participant Flow

We performed a randomized, controlled trial during June 1, 2010 through August 31, 2010 at a large academic, tertiary care facility. We included all admitted adult patients who experienced a 0.5 mg/dl change in serum creatinine over 48 hours following an active, recurring order for one or more targeted nephrotoxic or renally cleared medications.

Patients who were dialyzed prior to the first serum creatinine change event or identified as a dialysis patient through a dialysis flag order, in addition to those admitted to renal transplant, liver transplant, or nephrology services were excluded.

Participant milestones

Participant milestones
Measure
Dashboard
Patients appear on dashboard and are eligible for pharmacy intervention in addition to existing clinical decision support interventions.
Control
Patients do not appear on dashboard for pharmacy intervention, but only receive existing clinical decision support interventions.
Overall Study
STARTED
200
196
Overall Study
COMPLETED
200
196
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Achieving Medication Safety During Acute Kidney Injury

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Dashboard
n=200 Participants
Patients appear on dashboard and are eligible for pharmacy intervention in addition to existing clinical decision support interventions.
Control
n=196 Participants
Patients do not appear on dashboard for pharmacy intervention, but only receive existing clinical decision support interventions.
Total
n=396 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Age, Categorical
Between 18 and 65 years
111 Participants
n=99 Participants
120 Participants
n=107 Participants
231 Participants
n=206 Participants
Age, Categorical
>=65 years
89 Participants
n=99 Participants
76 Participants
n=107 Participants
165 Participants
n=206 Participants
Age Continuous
60.7 years
STANDARD_DEVIATION 16.8 • n=99 Participants
58.3 years
STANDARD_DEVIATION 15.7 • n=107 Participants
59.5 years
STANDARD_DEVIATION 16.3 • n=206 Participants
Sex: Female, Male
Female
94 Participants
n=99 Participants
77 Participants
n=107 Participants
171 Participants
n=206 Participants
Sex: Female, Male
Male
106 Participants
n=99 Participants
119 Participants
n=107 Participants
225 Participants
n=206 Participants
Region of Enrollment
United States
200 participants
n=99 Participants
196 participants
n=107 Participants
396 participants
n=206 Participants

PRIMARY outcome

Timeframe: Until patient discharge (~2 week average)

Our primary outcome measured the rate of AKI-related ADEs and pADEs. We defined pADEs as incidents with the potential for injury related to a drug, such as use of a non-steroidal anti-inflammatory drug for at least 24 hours, and ADEs as injuries resulting from the administration of a drug, such as a toxic vancomycin trough level or a bleed after administration of enoxaparin. We measured outcomes after completion of the inpatient encounter (either by death or discharge); pADEs or ADEs occurring after patient discharge were not included in the analysis.

Outcome measures

Outcome measures
Measure
Dashboard
n=1396 Patient-Medication Pairs
Patients appear on dashboard and are eligible for pharmacy intervention in addition to existing clinical decision support interventions.
Control
n=1303 Patient-Medication Pairs
Patients do not appear on dashboard for pharmacy intervention, but only receive existing clinical decision support interventions.
Adverse Drug Events or Potential Adverse Drug Events
99 Patient-Medication Pairs
104 Patient-Medication Pairs

SECONDARY outcome

Timeframe: Until patient discharge (~2 week average)

Time from study event to modification or discontinuation of targeted medication

Outcome measures

Outcome measures
Measure
Dashboard
n=1396 Patient-Medication Pairs
Patients appear on dashboard and are eligible for pharmacy intervention in addition to existing clinical decision support interventions.
Control
n=1303 Patient-Medication Pairs
Patients do not appear on dashboard for pharmacy intervention, but only receive existing clinical decision support interventions.
Time to Provider Response
Ordered Prior to AKI
23.7 Hours
Interval 5.61 to 57.67
27.31 Hours
Interval 5.98 to 62.57
Time to Provider Response
Ordered After AKI
42.37 Hours
Interval 17.9 to 77.93
43.83 Hours
Interval 17.62 to 80.58

Adverse Events

Dashboard

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Control

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Allison B. McCoy, PhD

The University of Texas Health Science Center at Houston (UTHealth)

Phone: 713-500-6931

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place