NCT00370916

Reducing Transition Drug Risk

Reducing Transition Drug Risks After Patient Transfer

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 612 (actual)
• Sponsor: US Department of Veterans Affairs · Federal
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

Patient transfer between sites of care is regular practice during an episode of care in our current health care system. Yet inter-site transfer is associated with lapses in care quality that adversely affect patient outcomes. A common iatrogenic harm precipitated at the time of transfer is harm from drug prescribing, or adverse drug events (ADEs). In this study we will evaluate a medication reconciliation tool developed to help providers make effective prescribing decisions at the time of transfer between VA sites of care (Improved Prescribing after Transfer (IPT)). We will evaluate the quantitative effectiveness of the tool in reducing transition drug risk and ADEs. We additionally will conduct focus group discussions and cognitive task analysis among end-users to better understand how providers make drug-prescribing decisions at the time of transfer and to assess factors influencing effective use of the tool.

Detailed description

This is a 2-phase study in which we will employ mixed quantitative and qualitative methods to conduct an evaluation of the IPT tool while improving our understanding of provider prescribing decisions at the time of patient transfer. In Phase 1 we will conduct a 5-month controlled trial among all admissions to 2 units at J.J. Peters (Bronx) VA Medical Center. We will compare IPT with usual care, and compare physician and pharmacist forms of IPT implementation with regard to, as primary outcome, transition drug risk, and, as secondary outcomes, ADEs, provider prescribing-decisions, and hospital utilization. In Phase 2, which will run concurrently with Phase 1, we will perform cognitive task analysis to examine providers' decision-making and to map IPT tool functions while providers interface with the tool, and perform focus group interviews with representative IPT users to identify factors that facilitate or hinder adoption. Results of cognitive analysis and focus groups will be used to identify tool deficiencies to consider for redesign.

Conditions

• Hospitalization

Interventions

Type	Name	Description
BEHAVIORAL	Physician-initiated medication reconciliation	Physician house staff performed and documented medication reconciliation after hospital admission with the assistance of a CPRS template
BEHAVIORAL	Pharmacist-initiated medication reconciliation	Pharmacist performed and documented medication reconciliation

Timeline

• Start date: 2005-10-01
• Primary completion: 2006-03-01
• Completion: 2010-09-01
• First posted: 2006-09-01
• Last updated: 2015-04-07

Locations

1 site across 1 country: United States