Pragmatic Cluster Trial for Nursing Home Antipsychotic Prescribing

Summary

Two arm, pragmatic, cluster-randomized trial, with nursing homes allocated to the full, active intervention (featuring educational outreach offered to each prescriber and team members in the home) or standard quality improvement supports (including online audit and feedback reports for each prescriber in the home). The 'standard' quality improvement supports represent 'usual care' as these are to be launched province-wide; a concurrent control arm with no exposure to a quality improvement intervention is not feasible.

Conditions

• Adverse Effect of Other Antipsychotics and Neuroleptics

Interventions

BEHAVIORAL

Audit + Feedback

Online Audit + Feedback practice reports detailing prescribing performance for this class of medication for each prescriber in the nursing home. (Details: http://www.hqontario.ca/Quality-Improvement/Practice-Reports/Primary-Care)

BEHAVIORAL

Audit + Feedback + Educational Outreach

The Educational Outreach program will be delivered by academic detailers, health professionals (often nurses or pharmacists) who have received specific intensive training to support prescribing providers in a particular environment, in this case long-term care homes, to make the best or appropriate clinical decisions as possible. It is defined as: "an innovative method of service-oriented educational outreach for front-line clinicians. It combines the interactive, one-on-one communication approach of industry detailers with the evidence-based, non-commercial information of academia." The Educational Outreach will be delivered in addition to online Audit + Feedback practice reports, which detail prescribing performance for this class of medication for each prescriber in the nursing home.

Sponsors & Collaborators

• Ontario Ministry of Health and Long Term Care

  collaborator OTHER_GOV

• Ontario Medical Association

  collaborator OTHER

• Health Quality Ontario

  collaborator OTHER

• Centre for Effective Practice

  collaborator OTHER

• Women's College Hospital

  lead OTHER

Principal Investigators

• Noah Ivers · Family Doctor and Research Scientist

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

PARALLEL

Eligibility

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2015-09-30

Primary Completion

2017-04-30

Completion

2017-04-30