Prescribing Practices Feedback for Older Patients

(EQUIPPED Trial)

Recruiting at 3 trial locations

Overseen By Jessica Kelleher, MS BS

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Non-VA providers, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

74 Participants Needed

Trial Summary

What is the purpose of this trial?

This research is being conducted to learn which implementation strategy of EQUIPPED is most effective to improve prescribing practices of ED providers toward older Veterans and determine the factors influencing implementation of this program to reduce the prescribing of PIMs to older adults upon discharge from the ED. The study has three research aims. The procedures for these research aims are described below: * Aim 1 - Examining the Impact of Passive Provider Feedback vs. Active Provider Feedback Through a Randomized Trial * Aim 2 - Determination of Factors Affecting Organizational Adoption of EQUIPPED * Aim 3 - Micro-Costing the Active and Passive Feedback Versions of the EQUIPPED Intervention

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

Eligibility Criteria

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

are not to prescribe more than a seven day supply of opioids for a new patient for any reason

will work with study coordinators to ensure that all EQUIPPED study procedures are followed

Exclusion Criteria

Providers at VA Medical Centers that are not part of the upcoming EQUIPPED implementation trial.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Implementation

Implementation of EQUIPPED with active or passive provider feedback to reduce PIMs prescribing

12 months

Monthly feedback sessions

Follow-up

Participants are monitored for changes in prescribing behavior and implementation factors

12 months

Treatment Details

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.

Participant Groups

Group I: Active Feedback Active Control 1 Intervention

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.

Group II: Passive Feedback Active Control 1 Intervention

EQUIPPED with passive provider feedback, implementing monthly provider feedback via an electronic dashboard with audit, feedback and peer benchmarking.

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Birmingham, Alabama VA Medical Center

Collaborator

Trials

4

Recruited

530+

Durham VA Health Care System

Collaborator

Trials

8

Recruited

64,900+

VA Salt Lake City Health Care System

Collaborator

Trials

25

Recruited

262,000+