Polypharmacy
Conditions
Keywords
multiple chronic conditions
Brief summary
The purpose of the proposed project is to pilot-test in the clinic setting a computer-based clinical decision support system (CDSS) designed to optimize medication prescribing for older persons with multiple chronic conditions and polypharmacy.
Interventions
OTHERCOMET
The intervention consists of completion of the tool by means of a telephone interview prior to the primary care visit and provision of the tool's output to the patient and PCP.
Sponsors
VA Connecticut Healthcare System
Yale University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Veterans age 65 years and older. * Patients should be diagnosed with diabetes and hypertension and be prescribed five or more medications. * Patients receiving primary care at the West Haven campus of VA Connecticut Healthcare System.
Exclusion criteria
* Unable to manage own medications because of cognitive impairment. * Medications prescribed by physician outside of the VA. * Severe vision or hearing impairment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patient Assessment of Care for Chronic Conditions (PACIC) | Immediately following the primary care visit at which the patient is enrolled in the study | A modified version of the Patient Assessment of Care for Chronic Conditions (PACIC) will be used. The original tool is a 20 item instrument (100 points total) designed to assess a patients perception of one's health care (for chronic conditions). A higher score indicates a more favorable rating. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of changes made to the medication regimen | 3 Month Follow Up | A chart review will be completed of the 3 months following the clinic appointment at which the patient is enrolled in the study to document any changes that were made to the medication regimen. |
| Coding of audiotapes of primary care visit | The primary care visit at which the patient is enrolled in the study | The Active Patient Participation Coding Scheme (APPC) is a validated instrument to assess indicators and facilitators of patient participation. Audio recordings will also be coded for evidence of providers' partnership building in the form of verbal encouragement to ask questions, express opinions, talk about their feelings, and participate in decision making. |
Countries
United States
Outcome results
None listed