Reducing Potentially Inappropriate Medication Prescribing for Older Patients in the ED

Summary

This research is being conducted to learn which implementation strategy of EQUIPPED is most effective to improve prescribing practices of ED providers toward older Veterans and determine the factors influencing implementation of this program to reduce the prescribing of PIMs to older adults upon discharge from the ED. The study has three research aims. The procedures for these research aims are described below:

* Aim 1 - Examining the Impact of Passive Provider Feedback vs. Active Provider Feedback Through a Randomized Trial
* Aim 2 - Determination of Factors Affecting Organizational Adoption of EQUIPPED
* Aim 3 - Micro-Costing the Active and Passive Feedback Versions of the EQUIPPED Intervention

Conditions

• Aging

Interventions

OTHER

EQUIPPED with Active Feedback

Enhancing Quality of Prescribing Practices for Older Adults Discharged from the Emergency Department (EQUIPPED is a multi-component program to reduce the prescribing of potentially inappropriate medications (PIMs) to older adults upon discharge from the Emergency Department (ED). It has three core components: 1) provider education, 2) Electronic Health Record (EHR)-based clinical decision support (CDS) including pharmacy quick order sets to facilitate provider order entry, and 3) provider audit and feedback with peer benchmarking. The active feedback group will receive one-to-one (1:1) in-person academic detailing from a professional colleague that includes in-person audit, feedback, and peer benchmarking and provide on-site expertise.

OTHER

EQUIPPED with Passive Feedback

Enhancing Quality of Prescribing Practices for Older Adults Discharged from the Emergency Department (EQUIPPED is a multi-component program to reduce the prescribing of potentially inappropriate medications (PIMs) to older adults upon discharge from the Emergency Department (ED). It has three core components: 1) provider education, 2) Electronic Health Record (EHR)-based clinical decision support (CDS) including pharmacy quick order sets to facilitate provider order entry, and 3) provider audit and feedback with peer benchmarking. The passive feedback group will receive monthly provider feedback via an electronic dashboard with audit, feedback and peer benchmarking.

Sponsors & Collaborators

• Durham VA Health Care System

  collaborator FED

• VA Salt Lake City Health Care System

  collaborator FED

• Birmingham, Alabama VA Medical Center

  collaborator FED

• VA Office of Research and Development

  lead FED

Principal Investigators

• Elizabeth Camille Vaughan, MD MS · Atlanta VA Medical and Rehab Center, Decatur, GA

• George Lee Jackson, PhD MHA · Durham VA Medical Center, Durham, NC

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2019-10-01

Primary Completion

2022-12-31

Completion

2024-12-31

Countries

• United States

Study Locations