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Sponsors and Collaborators: |
University of Massachusetts Baycrest Centre for Geriatric Care Agency for Healthcare Research and Quality (AHRQ) |
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Information provided by: | University of Massachusetts |
ClinicalTrials.gov Identifier: | NCT00599209 |
The magnitude and intensity of medication use among our nation's 1.6 million nursing home residents matches or exceeds that of hospitalized patients. The residents of nursing homes are among the most frail patients in the population; the challenges of using medications in this setting are great, not only because of the physiologic declines and pharmacologic changes that occur with aging, but also because of the special clinical and social circumstances that often characterize nursing home care. In our previous research, we have determined that medication errors resulting in adverse drug events occur most often at the ordering and monitoring stages of pharmaceutical care. Clinical decision-support systems are clinical consultation systems that combine individual patient information with population statistics and scientific evidence to offer real-time information to health care providers. These systems have been found to improve the quality of medication prescribing in the hospital setting. In this study, we intend to determine the extent to which a computer-based clinical decision-support system (accompanying computerized provider order-entry) can improve the quality of medication ordering and monitoring for residents in the long-term care setting through a randomized trial. We will track the costs associated with this system and the system's impact on the productivity of providers. We will also assess the culture of U.S. nursing homes and the organization of the nursing home setting with respect to readiness to incorporate computerized provider order-entry with computer-based clinical decision support. Our project addresses specific areas that are of particular interest to AHRQ with special relevance to the delivery of high-quality care to a priority population--the frail elderly patient population residing in nursing homes. The project will assess the economic implications of health information technology in the nursing home environment that will be of interest to key stakeholders, including physicians, pharmacists, nurses, payers, policymakers, the nursing home industry, and pharmaceutical vendors to long-term care institutions.
Condition | Intervention |
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Patient Safety Prescribing Practices Laboratory Monitoring Practices |
Other: clinical decision support |
Study Type: | Interventional |
Study Design: | Health Services Research, Randomized, Open Label, Parallel Assignment |
Official Title: | Health Information Technology in the Nursing Home |
Enrollment: | 23 |
Study Start Date: | September 2004 |
Estimated Study Completion Date: | September 2008 |
Estimated Primary Completion Date: | September 2008 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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A - coded unit ID: Experimental
Nursing home units provided the CDS intervention
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Other: clinical decision support
CDS is provided to prescribers on intervention units upon ordering medication which offers advice on prescribing and monitoring practices
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B - coded unit ID: No Intervention
Nursing home units not provided the CDS intervention
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Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
Exclusion Criteria:
United States, Massachusetts | |
Meyers Primary Care Institute | |
Worcester, Massachusetts, United States, 01605 |
Principal Investigator: | Jerry H Gurwitz, MD | Meyers Primary Care Institute |
Responsible Party: | Meyers Primary Care Institute/University of Massachusetts Medical School ( Jerry Gurwitz, MD Executive Director ) |
Study ID Numbers: | 11390, 5 R01 HS15430 |
Study First Received: | January 11, 2008 |
Last Updated: | May 20, 2008 |
ClinicalTrials.gov Identifier: | NCT00599209 History of Changes |
Health Authority: | United States: Institutional Review Board |