A Randomized Control Trial Testing a Medication Safety Dashboard in Veteran Transplant Recipients
INTRODUCTION: Medication errors, adverse events, and nonadherence in organ transplant recipients are common and can lead to suboptimal outcomes. A medication safety dashboard was developed to identify issues in medication therapy.
RESEARCH QUESTIONS: Can a multicenter bioinformatics dashboard accurately identify clinically relevant medication safety issues in US military Veteran transplant recipients?.
DESIGN: The dashboard was tested through a 24-month, prospective, cluster-randomized controlled multicenter study. Pharmacists used the dashboard to identify and address potential medication safety issues, which was compared with usual care.
RESULTS: Across the 10 sites (5 control sites and 5 intervention sites), 2012 patients were enrolled (1197 intervention vs 831 control). The mean age was 65 (10) years, 95% male, and 27% Black. The dashboard produced 18 132 alerts at a rate of 0.61(0.32) alerts per patient-month, ranging from 0.44 to 0.72 across the 5 intervention sites. Lab-based issues were most common (83.4%), followed by nonadherence (9.4%) and transitions in care (6.4%); 56% of alerts were addressed, taking an average of 43 (29) days. Common responses to alerts included those already resolved by another provider (N = 4431, 44%), the alert not clinically relevant (N = 3131, 31%), scheduling of follow-up labs (N = 591, 6%), and providing medication reconciliation/education (N = 99, 1%). Inaccurate flags significantly decreased over the study by a mean of -0.6% per month (95% CI -0.1 to -1.0; P = .0265), starting at 13.4% and ending at 2.6%.
CONCLUSION: This multicenter cluster-randomized controlled trial demonstrated that a medication safety dashboard was feasibly deployable across the VA healthcare system, creating valid alerts.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:33 |
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| Enthalten in: |
Progress in transplantation (Aliso Viejo, Calif.) - 33(2023), 2 vom: 10. Juni, Seite 121-129 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Taber, David J [VerfasserIn] |
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| Links: |
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| Themen: |
Clinical decision support systems |
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| Anmerkungen: |
Date Completed 01.05.2023 Date Revised 23.05.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/15269248231164177 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a INTRODUCTION: Medication errors, adverse events, and nonadherence in organ transplant recipients are common and can lead to suboptimal outcomes. A medication safety dashboard was developed to identify issues in medication therapy | ||
| 520 | |a RESEARCH QUESTIONS: Can a multicenter bioinformatics dashboard accurately identify clinically relevant medication safety issues in US military Veteran transplant recipients? | ||
| 520 | |a DESIGN: The dashboard was tested through a 24-month, prospective, cluster-randomized controlled multicenter study. Pharmacists used the dashboard to identify and address potential medication safety issues, which was compared with usual care | ||
| 520 | |a RESULTS: Across the 10 sites (5 control sites and 5 intervention sites), 2012 patients were enrolled (1197 intervention vs 831 control). The mean age was 65 (10) years, 95% male, and 27% Black. The dashboard produced 18 132 alerts at a rate of 0.61(0.32) alerts per patient-month, ranging from 0.44 to 0.72 across the 5 intervention sites. Lab-based issues were most common (83.4%), followed by nonadherence (9.4%) and transitions in care (6.4%); 56% of alerts were addressed, taking an average of 43 (29) days. Common responses to alerts included those already resolved by another provider (N = 4431, 44%), the alert not clinically relevant (N = 3131, 31%), scheduling of follow-up labs (N = 591, 6%), and providing medication reconciliation/education (N = 99, 1%). Inaccurate flags significantly decreased over the study by a mean of -0.6% per month (95% CI -0.1 to -1.0; P = .0265), starting at 13.4% and ending at 2.6% | ||
| 520 | |a CONCLUSION: This multicenter cluster-randomized controlled trial demonstrated that a medication safety dashboard was feasibly deployable across the VA healthcare system, creating valid alerts | ||
| 650 | 4 | |a Randomized Controlled Trial | |
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| 700 | 1 | |a Cooney, Danielle |e verfasserin |4 aut | |
| 700 | 1 | |a Super, Nicholas |e verfasserin |4 aut | |
| 700 | 1 | |a McClelland, Samantha |e verfasserin |4 aut | |
| 700 | 1 | |a Buchanan, Casey |e verfasserin |4 aut | |
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