Improving Safety By Computerizing Outpatient Prescribing
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Purpose
Patient safety is at the forefront of critical issues in health care. Medications are the single most frequent cause of adverse events, and in the inpatient setting adverse drug events (ADEs) are common, expensive, injurious to patients, and often preventable. Relatively little, however, is known about the frequency of ADEs in the ambulatory setting, how to monitor for outpatient ADEs, or on the impact of prevention strategies such as computerization of prescribing supplemented by decision-support.
| Condition | Intervention |
|---|---|
|
Impact of Electronic Prescribing on Medication Safety |
Other: Adverse Drug Event Monitoring |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Caregiver) Primary Purpose: Treatment |
| Official Title: | Improving Safety By Computerizing Outpatient Prescribing |
- Preventable Adverse drug events [ Time Frame: 8/5/2004 - 1/5/2005 ] [ Designated as safety issue: Yes ]Data were electronically collected each time a physician entered a prescription that triggered an alert related to medication safety.
- Total adverse drug events, medication errors [ Time Frame: 1/15/2001 - 5/15/2001 ] [ Designated as safety issue: Yes ]
| Enrollment: | 701 |
| Study Start Date: | August 2000 |
| Study Completion Date: | December 2010 |
| Primary Completion Date: | December 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Adverse Drug Event Monitoring
In this intervention arm, clinicians received medication safety alerts when they prescribed medications in the electronic medical record.
|
Other: Adverse Drug Event Monitoring
The intervention in this study is the presentation of medication safety alerts in the electronic medical record to improve patient outcomes and safety.
|
|
No Intervention: Care as Usual
In this arm, clinicians did not receive the medication safety alerts.
|
Other: Adverse Drug Event Monitoring
The intervention in this study is the presentation of medication safety alerts in the electronic medical record to improve patient outcomes and safety.
|
Detailed Description:
Specific Aim 1: Increase routine identification of outpatient adverse drug events (ADEs) through development of a computerized ADE detection monitor.
Specific Aim 2: Use basic computerized outpatient prescribing to reduce preventable ADEs in a diverse array of outpatient settings.
Specific Aim 3: Use advanced decision-support within computerized prescribing to reduce the frequency of preventable ADEs, medication errors, and potential ADEs.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria: At Brigham & Women's Hospital, clinics utilizing the electronic medical record will be included. At Regenstrief, any clinic that has access to their electronic medical record will be utilized.
- For the impact of basic decision support, clinics were not randomized
- For impact of advanced decision support, clinics were randomized to receive the intervention
Exclusion Criteria:
- Clinics not using electronic medical records
Contacts and Locations| United States, Indiana | |
| Regenstrief/Indiana University | |
| Indianapolis, Indiana, United States | |
| United States, Massachusetts | |
| Brigham and Women's Hospital | |
| Boston, Massachusetts, United States, 02115 | |
| Study Director: | Tejal K Gandhi, MD, MPH | Brigham and Women's Hospital |
| Principal Investigator: | David Bates, MD | Brigham and Women's Hospital |
| Study Director: | Marc Overhage, MD | Regenstrief Institute, IU Center for Aging Research |
More Information
Additional Information:
Publications:
| Responsible Party: | david bates, Chief of General Internal Medicine, BWH, Agency for Healthcare Research and Quality (AHRQ) |
| ClinicalTrials.gov Identifier: | NCT00235027 History of Changes |
| Other Study ID Numbers: | RO1 HS 11169 |
| Study First Received: | October 6, 2005 |
| Last Updated: | July 12, 2012 |
| Health Authority: | United States: Federal Government |
ClinicalTrials.gov processed this record on June 18, 2013