Care Planning for Older Persons With Multiple Conditions: Encouraging a Tailored Approach (COMET): Stage II

NCT02501967 | Completed

• 1 other identifier: 1410014812
• Study Type: interventional
• Target: 128
• Locations: 1 country
• Sites: 1

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.

Conditions

Polypharmacy

Keywords

multiple chronic conditions

Outcome Measures

Primary Outcomes (1)

• Patient Assessment of Care for Chronic Conditions (PACIC)

  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.

  Immediately following the primary care visit at which the patient is enrolled in the study

Secondary Outcomes (2)

• Number of changes made to the medication regimen

  3 Month Follow Up

• Coding of audiotapes of primary care visit

  The primary care visit at which the patient is enrolled in the study

Study Arms (2)

COMET

EXPERIMENTAL

The intervention consists of completion of the tool (COMET) by means of a 30 minute telephone interview prior to the primary care visit and provision of the tool's output to the patient and primary care physician. The COMET tool takes information about the patient's medications and chronic conditions from the electronic health record, and then supplements this with information obtained by a telephone interview assessing the patient's cognition, social supports, medication adherence, home medication regimen, medication side effects, and health status. In addition, there is a chart review screen to record renal function, blood pressure, and hemoglobin A1C. All of this information is run through a set of algorithms to identify medication reconciliation errors and potentially inappropriate medications.

Other: COMET

Usual Care

NO INTERVENTION

Interventions

COMET OTHER

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.

COMET

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• 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.

You may not qualify if:

• Unable to manage own medications because of cognitive impairment.
• Medications prescribed by physician outside of the VA.
• Severe vision or hearing impairment.

Sponsors & Collaborators

• Yale University: lead
• VA Connecticut Healthcare System: collaborator

Study Sites (1)

VA Connecticut Healthcare

West Haven, Connecticut, 06516, United States

Location

MeSH Terms

Conditions

Multiple Chronic Conditions

Condition Hierarchy (Ancestors)

Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Terri R Fried, MD

  Yale University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 8, 2015
• First Posted: July 17, 2015
• Study Start: April 1, 2014
• Primary Completion: April 1, 2016
• Study Completion: May 1, 2016
• Last Updated: August 24, 2016

Record last verified: 2016-08

Locations

US (1)