Heart Diseases Clinical Trial
Official title:
Effect of Synapse Medicine Decision Support on Inpatient Pharmacist Efficacy and Efficiency: a Hybrid Type 2 Implementation Study
Adverse drug events (ADE) are common and dangerous in the hospital and following discharge to the ambulatory setting. One cause of ADEs in both settings is medication regimen inappropriateness, including polypharmacy, drug-drug interactions, and medications that are inappropriate or inappropriately dosed given patients' age, renal, and hepatic function. Hospitalization provides a good opportunity to investigate medication appropriateness given new or worsening conditions and available expertise. Inpatient pharmacists are medication experts and often round with medical teams, but they may not always have all the information available at their fingertips to make optimal recommendations regarding medication appropriateness for each patient. Clinical decision support to pharmacists at the point of care has potential to improve the speed, quantity, and quality of medication recommendations to inpatient teams; any subsequent improvements to medication regimen appropriateness have the potential to reduce ADEs in the hospital and after discharge. Specific Aims and Objectives Aim 1: Implement real-time decision support regarding medication regimen appropriateness among pharmacists who round with inpatient medical teams. Aim 2: Determine the effects of this intervention on the number of medication regimen recommendations and time spent per recommendation Aim 3: Evaluate the use and usability of the decision support tool and develop strategies to mitigate barriers and promote facilitators of implementation using mixed methods implementation science approaches.
This will be a prospective pre-post mixed methods hybrid type 2 effectiveness-implementation study. The study will take place at BWH and at Vanderbilt University Medical Center (VUMC). The direct subjects will be the inpatient pharmacists (4 at each site) who round with general medicine teams. Patients will be indirect subjects as pharmacists provide medication recommendations regarding these patients to the clinicians on each team with or without the Synapse software. We estimate this number of patients to be 3 new admitted patients per day per team x 56 days x 8 teams = 1344 patients (672 at MGB sites). Patients can be any patients admitted to these general medicine service teams at BWH and VUMC. The pharmacists are trained hospital pharmacists who round with general medicine service teams and approve inpatient medication orders. There are no local site restrictions. VUMC will cede IRB approval to the MGB IRB. ;
Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
NCT04624412 -
Different Intensities of Continuous Aerobic Exercises in Cardiac Rehab Phase 2
|
N/A | |
Completed |
NCT05563701 -
Evaluation of the LVivo Image Quality Scoring (IQS)
|
||
Recruiting |
NCT04561908 -
Transcatheter Microguidewire Drilling for Transseptal Left Atrial Access
|
N/A | |
Active, not recruiting |
NCT06190743 -
Perception of Cardiovascular Risk
|
||
Completed |
NCT04562636 -
Evaluating a Messaging Campaign in the United States
|
N/A | |
Completed |
NCT04580095 -
Artificial Intelligence for Improved Echocardiography
|
N/A | |
Recruiting |
NCT03277365 -
MyGeneRank: A Digital Platform for Next-Generation Genetic Studies
|
N/A | |
Active, not recruiting |
NCT05553106 -
Evaluation of Cognitive Status, Kinesiophobia, Physical Activity Level, and Functional Performance in Coronary Intensive Care
|
||
Completed |
NCT03429920 -
Effect of Fermented Soy Based Product on Cardiometabolic Risk Factors
|
N/A | |
Recruiting |
NCT04390672 -
Multivessel TALENT
|
N/A | |
Enrolling by invitation |
NCT03314818 -
Natural History of Carotid Plaque as Determined by 3D Ultrasound
|
N/A | |
Withdrawn |
NCT03289104 -
Improving Sternal Healing After Cardiac Surgery: Sternal Wire vs ZIPFIX
|
N/A | |
Completed |
NCT02917213 -
Imaging Silent Brain Infarct And Thrombosis in Acute Myocardial Infarction
|
||
Completed |
NCT02046902 -
Developing and Testing a Personalized Evidence-based Shared Decision-making Tool for Stent Selection
|
||
Completed |
NCT01944254 -
The Precision of Pulmonary Artery Cardiac Output-measurements in Spontaneously Breathing Patients
|
N/A | |
Completed |
NCT01909349 -
Web-based Aftercare Intervention for Cardiac Patients
|
N/A | |
Recruiting |
NCT01457586 -
Hemoderivative Imputable Complications in Initial Uncomplicated Heart Surgery
|
Phase 4 | |
Recruiting |
NCT01207167 -
Mediators of Atherosclerosis in South Asians Living in America
|
||
Recruiting |
NCT01541163 -
Heart and Ischemic STrOke Relationship studY
|
N/A | |
Completed |
NCT02645786 -
Thyrotropin Over-suppression and Heart
|
N/A |