Prescribing Practices Feedback for Older Patients
(EQUIPPED Trial)
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial aims to identify the best method for helping doctors at VA Medical Centers prescribe safer medications to older veterans upon discharge from the emergency department. Two approaches are being tested: one involves face-to-face feedback from a colleague (EQUIPPED with Active Feedback), while the other uses an online dashboard for feedback (EQUIPPED with Passive Feedback). The goal is to reduce the use of potentially inappropriate medications (PIMs) for older adults. This trial suits healthcare providers at VA Medical Centers participating in the EQUIPPED program. As an unphased trial, it offers healthcare providers a unique opportunity to contribute to innovative approaches in medication safety for older veterans.
Do I need to stop taking my current medications for this trial?
The trial information does not specify whether participants need to stop taking their current medications.
What prior data suggests that the EQUIPPED implementation strategies are safe for older patients?
Research has shown that EQUIPPED, utilizing both active and passive feedback, focuses on improving medication safety for older adults. This program aids doctors in prescribing safer medications when patients leave the emergency department. Studies have demonstrated that EQUIPPED reduces the number of potentially inappropriate medications (PIMs) given to older adults.
For EQUIPPED with Active Feedback, results indicate that direct, in-person guidance helps doctors better understand their prescribing habits. This includes face-to-face meetings and expert advice, leading to safer prescribing practices.
For EQUIPPED with Passive Feedback, the program employs an electronic dashboard to provide monthly feedback. This system allows doctors to view their prescribing patterns and compare them with their peers, effectively promoting medication safety by increasing awareness of their prescribing choices.
Both methods have been implemented in various emergency departments and have shown a commitment to improving patient safety without major safety concerns. Since the trial does not involve new drugs but rather a method of providing feedback, it is generally considered safe for participants.12345Why are researchers excited about this trial?
Researchers are excited about the EQUIPPED approach because it introduces innovative ways to improve prescribing practices for older patients. Unlike standard care, which often lacks personalized feedback, the Active Feedback method incorporates one-to-one in-person academic detailing from a professional colleague, along with peer benchmarking and on-site expertise. This personalized interaction is hoped to enhance the effectiveness of prescribing practices through direct, tailored guidance. Meanwhile, the Passive Feedback method provides monthly electronic feedback via a dashboard, offering a streamlined, data-driven approach that emphasizes continuous audit and feedback. Both methods aim to refine prescribing habits, potentially leading to safer and more effective medication use in older adults.
What evidence suggests that the EQUIPPED feedback methods are effective for improving prescribing practices for older patients?
Research has shown that the EQUIPPED program reduces the prescription of potentially inappropriate medications (PIMs) for older adults. In this trial, participants will receive one of two feedback methods. The first, active feedback, involves in-person training sessions. This approach significantly lowers PIM prescriptions by offering personalized advice to healthcare providers, helping them improve their prescribing habits. The second method, passive feedback, uses an electronic dashboard to provide regular updates and peer comparisons. This method also reduces PIMs but relies on providers checking the dashboard independently. Both methods aim to improve prescribing practices, but studies suggest that active feedback might lead to better results.34567
Who Is on the Research Team?
Elizabeth Camille Vaughan, MD MS
Principal Investigator
Atlanta VA Medical and Rehab Center, Decatur, GA
George Lee Jackson, PhD MHA
Principal Investigator
Durham VA Medical Center, Durham, NC
Are You a Good Fit for This Trial?
This trial is for prescribers and members of the EQUIPPED implementation team at VA Medical Centers that are starting to use EQUIPPED. It's focused on improving how doctors prescribe medication to older veterans in the emergency department (ED) to avoid inappropriate medications.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Implementation
Implementation of EQUIPPED with active or passive provider feedback to reduce PIMs prescribing
Follow-up
Participants are monitored for changes in prescribing behavior and implementation factors
What Are the Treatments Tested in This Trial?
Interventions
- EQUIPPED with Active Feedback
- EQUIPPED with Passive Feedback
Trial Overview
The study tests two ways of giving feedback to ED providers using EQUIPPED: 'Passive Feedback' where they get general updates, and 'Active Feedback' with more direct guidance. The goal is to see which method better reduces unsuitable prescriptions for elderly patients.
How Is the Trial Designed?
2
Treatment groups
Active Control
EQUIPPED with active provider feedback, implementing 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.
EQUIPPED with passive provider feedback, implementing monthly provider feedback via an electronic dashboard with audit, feedback and peer benchmarking.
Find a Clinic Near You
Who Is Running the Clinical Trial?
VA Office of Research and Development
Lead Sponsor
Birmingham, Alabama VA Medical Center
Collaborator
Durham VA Health Care System
Collaborator
VA Salt Lake City Health Care System
Collaborator
Citations
EQUIPPED (Enhancing Quality of Prescribing Practices for ...
Purpose: We proposed an implementation study to evaluate adaptation in non-VA health systems of the. EQUIPPED (Enhancing Quality of Prescribing Practices for ...
EQUIPPED for Safe Prescribing in the Emergency Department
Initially designed as a quality improvement initiative to reduce potentially inappropriate medication prescribing for adults aged 65+ years, ...
Reducing Potentially Inappropriate Medication Prescribing ...
The overall goal of this project is to determine which EQUIPPED implementation strategy (active or passive feedback) is most effective to reduce prescribing of ...
4.
ce.advocatehealth.org
ce.advocatehealth.org/sites/default/files/course/2024-11/6.%20How%20to%20Prescribe%20Age%20Friendly%20Medications%20for%20Older%20Adults-%20Lessons%20Learned%20from%20Equipped_Camille%20Vaughan.pdfEQUIPPED for Age-Friendly Prescribing in the ED
To compare the effectiveness of active vs passive feedback EQUIPPED intervention by comparing the monthly proportion of PIM prescribing as % of individual ...
The Enhancing Quality of Prescribing Practices for Older ...
Although the EQUIPPED program is effective at reducing the prescribing of potentially inappropriate medications, the reliance on in-person academic detailing ...
Use of a Medication Safety Audit and Feedback Tool in the ...
The EQUIPPED dashboard provides emergency department (ED) providers with a personalized view of their prescribing performance informed by the ...
Early prescribing outcomes after exporting the EQUIPPED ...
Early prescribing outcomes after exporting the EQUIPPED medication safety improvement programme. Camille P Vaughan.
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