Multifaceted Intervention to Improve Prescribing in Patients With Chronic Kidney Disease
Recruitment status was: Not yet recruiting
In 2001, an estimated 1.9 million Canadians had chronic renal disease and the number of patients being treated for end stage renal disease climbed by nearly 20% in 5 years. Many medications commonly used in elderly patients are excreted by the kidney. Failure to adjust doses in those with impaired renal function can result in medication overdose, leading to potentially serious morbidity and mortality. Studies in hospitals and long term care facilities have found a 19-67% rate of non-compliance with guidelines for medication dose adjustment in patients with renal insufficiency and in ambulatory care one study found a 69% rate of non-compliance. Since primary care physicians write 80% of prescriptions for those aged 65 years, there is a need for interventions to improve prescribing to patients with renal impairment in primary care.
This study will develop an audit tool and electronic decision support tool that will be incorporated into the electronic medical record in a large academic family health centre. It is seen as a preliminary step in a project to assess the effectiveness of a multifaceted intervention including chart audit, personalized feedback to prescribers, a pharmacist-facilitated group learning session and the use of an electronic decision support tool incorporated into the electronic medical record.
Chronic Kidney Disease
Behavioral: computer decision support tool
Behavioral: audit and feedback
Behavioral: group learning session
|Study Design:||Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Health Services Research
|Official Title:||Multifaceted Intervention to Improve Prescribing of Medications Requiring Dose Adjustment in Patients With Chronic Kidney Disease|
- The primary outcome will be a change in the number of appropriately written prescriptions for the targeted medications 3 and 6 months after the educational intervention and introduction of the clinical decision support tool.
- Prescribers’ perception of their knowledge of and comfort with adjusting doses of medications as measured in a Likert scale and their assessement of the ease of use of the decision support tool
- , cost savings, time for prescribers to use the decision support tool, number of times the decision support tool was used.
|Study Start Date:||March 2007|
|Estimated Study Completion Date:||March 2007|
Please refer to this study by its ClinicalTrials.gov identifier: NCT00446615
|Stonechurch Family Health Centre|
|Hamilton, Ontario, Canada, L8W 3J6|
|Principal Investigator:||Imaan Bayoumi||McMaster University|
|Principal Investigator:||Lisa McCarthy||McMaster University|