Reducing Adverse Drug Events in the Nursing Home

This study has been completed.
Sponsor:
Collaborators:
Baycrest Centre for Geriatric Care
Information provided by:
University of Massachusetts, Worcester
ClinicalTrials.gov Identifier:
NCT00606606
First received: January 11, 2008
Last updated: May 20, 2008
Last verified: May 2008
  Purpose

Medications are the single most common form of treatment in the long-term care setting, and often represent the most efficacious (and cost-effective) therapeutic modality used in this clinical setting. However, the residents of nursing homes are at increased risk for experiencing adverse drug events. This risk is increased by the physiologic decline and pharmacologic changes that occur with aging, and also by the special clinical and social circumstances that characterize institutional long-term care. In a study funded by the National Institute on Aging (AG 14472), we have previously determined that adverse drug events are common and often preventable in the nursing home setting and that the more serious the adverse drug event, the more likely it is to be preventable. This study will test whether a computer-based clinical decision support system can lower the rate of adverse drug events (ADEs) and potential ADEs in the long-term care setting. The study design is a randomized trial based in the resident care units of two large long-term care facilities. Within each facility, half of the resident care units will be randomized to an intervention arm receiving the computer-based clinical decision support system which will display warnings, messages, and prompts based on resident and drug use characteristics; with over-rides by the prescriber required for some warnings. Rates of ADEs and potential ADEs will be tracked by the study's on-site clinical pharmacists prior to and during the intervention period. Rates will be compared between units receiving and not receiving the computer¬based clinical decision support system and to baseline, pre-intervention rates in the same units. We will track all project costs directly related to the development and installation of the computer-based clinical decision support system. We will also develop and test the sensitivity and specificity of a computerized adverse drug event monitor and assess the validity of a nursing home resident risk model developed in our prior study of adverse drug events in the nursing home setting.


Condition Intervention
Adverse Drug Events
Other: Clinical Decision Support

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Health Services Research
Official Title: Reducing Adverse Drug Events in the Nursing Home

Resource links provided by NLM:


Further study details as provided by University of Massachusetts, Worcester:

Primary Outcome Measures:
  • adverse drug events [ Time Frame: March 2002 - February 2005 ] [ Designated as safety issue: Yes ]

Enrollment: 0
Study Start Date: July 2000
Study Completion Date: June 2006
Primary Completion Date: February 2005 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: I - Intervention units
nursing home units, provided HIT CDS intervention
Other: Clinical Decision Support
Other Name: CDS
No Intervention: C - control units
nursing home units, not provided the HIT CDS intervention

  Show Detailed Description

  Eligibility

Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • prescriber at the study facilities

Exclusion Criteria:

  • not a prescriber at the study facilities
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00606606

Sponsors and Collaborators
University of Massachusetts, Worcester
Baycrest Centre for Geriatric Care
Investigators
Principal Investigator: Jerry H Gurwitz, MD Meyers Primary Care Institute
  More Information

No publications provided

Responsible Party: Jerry Gurwitz, Executive Director, Meyers Primary Care Institute/University of Massachusetts Medical School
ClinicalTrials.gov Identifier: NCT00606606     History of Changes
Other Study ID Numbers: 3843, 5 R01 HS010481
Study First Received: January 11, 2008
Last Updated: May 20, 2008
Health Authority: United States: Institutional Review Board

Additional relevant MeSH terms:
Drug Toxicity
Poisoning
Substance-Related Disorders

ClinicalTrials.gov processed this record on April 17, 2014