EVOLV-Rx Dashboard for Overutilization

Not yet recruiting at 2 trial locations

Overseen By Loren J Schleiden, MS

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Must not be taking: Benzodiazepines

Disqualifiers: Hospice care

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

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new tool called EVOLV-Rx, which helps doctors identify and reduce unnecessary medications prescribed to older adults. The main goal is to determine if this tool can decrease the prescribing of low-value medicines that may be unnecessary and potentially harmful. The trial compares usual care with the new tool to assess its effectiveness in various care centers. Veterans aged 65 or older, living in specific care centers and not receiving hospice care, might be suitable for this study. As an unphased trial, it offers participants the opportunity to contribute to improving medication safety for older adults.

Do I have to stop taking my current medications for this trial?

The trial does not specify if you need to stop taking your current medications. However, it aims to reduce low-value prescribing, which might involve changes to your medication. It's best to discuss your specific situation with the trial coordinators.

What prior data suggests that the EVOLV-Rx tool is safe for use in reducing low-value prescribing practices?

Research has shown that EVOLV-Rx is a tool designed to reduce unnecessary or potentially harmful prescriptions, particularly for older adults. It focuses on improving medication prescribing practices. Unlike a drug or medical device, EVOLV-Rx lacks traditional safety data. Instead, its safety relates to how effectively it aids doctors in prescribing more safely.

As this trial is in a "Not Applicable" phase, standard clinical trial phase data is unavailable. However, it is important to note that EVOLV-Rx does not introduce any new medication or treatment. It serves as a system to guide better prescribing decisions, so participants face no direct physical risks from using EVOLV-Rx itself.

In summary, EVOLV-Rx aims to enhance prescribing habits safely without introducing new risks to participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the EVOLV-Rx Dashboard because it offers a novel way to tackle the issue of overutilization in healthcare settings. Unlike traditional methods that rely on static protocols, the EVOLV-Rx Dashboard provides a dynamic, data-driven approach that allows each site to act as its own control. This adaptability ensures that all locations benefit from the intervention, potentially leading to more efficient resource use and improved patient outcomes across the board.

What evidence suggests that the EVOLV-Rx intervention is effective for reducing low-value prescribing?

Research has shown that EVOLV-Rx helps identify and reduce prescriptions that might not be needed or helpful for older adults. These unnecessary prescriptions are called low-value prescriptions. The tool aims to cut down on these prescriptions, which can help reduce the number of medications people take and improve the quality of their care. Early findings suggest that using EVOLV-Rx could lead to better management of medications for older adults, possibly lowering the total number of prescriptions they need. This approach is designed to improve the health and well-being of older Veterans by ensuring they only receive medications that are necessary and effective. ^{4 6 7 8 9}

Who Is on the Research Team?

Thomas R. Radomski, MD MS

Principal Investigator

VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA

Are You a Good Fit for This Trial?

This trial is for older veterans residing in Community Living Centers (CLCs) within VISN 4. It aims to reduce unnecessary medication prescriptions. Participants should be receiving care that may involve low-value prescribing practices.

Inclusion Criteria

I am a veteran over 65 in a VISN 4 CLC for a medication review.

Exclusion Criteria

I am a veteran in hospice care and stopping my medications might cause me discomfort.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Implementation Preparation

Focus groups conducted to identify barriers and facilitators for implementation and tailor strategies for intervention adoption

3 months

Intervention

Implementation of EVOLV-Rx intervention using a stepped wedge design to reduce low-value prescribing in CLCs

3.5 years

Follow-up

Participants are monitored for safety and effectiveness after treatment

6-12 months

What Are the Treatments Tested in This Trial?

Interventions

• EVOLV-Rx

Trial Overview The EVOLV-Rx dashboard, a clinical support tool designed to identify and decrease low-value prescribing among older adults, is being tested against usual care using a stepped wedge design across five CLCs.

How Is the Trial Designed?

Group I: Stepped Wedge Experimental Treatment 1 Intervention

As part of the Stepped Wedge design, each CLC serves as its own control rather than sites being allocated to distinct control and intervention arms. All sites will receive the intervention.

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8848205/

Development of a Metric to Detect and Decrease Low-Value ... Applying EVOLV-Rx may enhance the detection of low-value prescribing practices, reduce polypharmacy, and enable older adults to receive high- ...

2. clinicaltrials.gov clinicaltrials.gov/study/NCT07166107

EVOLV-Rx VA: Evaluating Opportunities to Decrease Low-Value ... The objective is to conduct a hybrid study to assess the effectiveness and implementation of an EVOLV-Rx-based intervention to reduce LVP among older Veterans ...

3. researchgate.net researchgate.net/publication/358631572_Development_of_a_Metric_to_Detect_and_Decrease_Low-Value_Prescribing_in_Older_Adults

(PDF) Development of a Metric to Detect and Decrease ... Applying EVOLV-Rx may enhance the detection of low-value prescribing practices, reduce polypharmacy, and enable older adults to receive high-value care across ...

4. pharmacypracticenews.com pharmacypracticenews.com/PrintArticle/71720

By Kate Baggaley Evaluating Opportunities to Decrease Low-Value Prescribing (EVOLV-Rx). This metric includes 18 “low-value” prescribing practices that cover ...

5. gim-crhc.pitt.edu gim-crhc.pitt.edu/people/thomas-r-radomski-md-ms

Thomas R. Radomski, MD, MS Radomski's research focuses on developing and implementing patient-centered approaches to measure and reduce health service overuse. He is currently the ...

6. evolveprosol.com evolveprosol.com/forms

Safety Data Sheets Safety Data Sheets provide chemical formula information facts ... Evolve Air Rx. Download File Download. Apr 25, 2025. Evolve Air Rx Pre-Treat.

7. evolv.com evolv.com/

Evolv Technology: Creating Safer Experiences The Evolv Safer Experience System™ helps deter, detect, and orchestrate response to physical security threats. ... Technology designed to detect weapons hidden ...

8. resources.finalsite.net resources.finalsite.net/images/v1665773854/midlandpsorg/ryfmnekf3isncdxnhff9/EvolveSafetyandOperatorDoc.pdf

Evolv Health & Safety Evolv Express® is a crowd screening system that keeps high volume entrances flowing by reliably detecting guns and metallic IEDs as visitors walk through at ...

9. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2789057

Development of a Metric to Detect and Decrease Low ... EVOLV-Rx is distinct from other metrics in that it applies a value-based paradigm to consolidate the hundreds of existing low-value prescribing ...