Effect of Synapse Medicine Decision Support on Inpatient Pharmacist Efficacy and Efficiency

NCT05459155 | Unknown

• 1 other identifier: 2022P000659
• Study Type: interventional
• Target: 672
• Locations: 0 countries
• Sites: N/A

Brief Summary

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.

Conditions

Infections; Heart Diseases; Lung Diseases; Kidney Diseases; Liver Diseases; Gastrointestinal Diseases

Keywords

Hospitalized Patients

Outcome Measures

Primary Outcomes (1)

• Change in the number of medication recommendations made per patient

  Change from pre- to post-intervention in the number of recommendations regarding medication changes made by pharmacists per patient

  pre- and post-intervention periods: 4 weeks each per pharmacist

Secondary Outcomes (1)

• Change in the time spent per recommendation per patient

  pre- and post-intervention periods: 4 weeks each per pharmacist

Study Arms (2)

Pharmacist team post-intervention

EXPERIMENTAL

The direct subjects will be the inpatient pharmacists who round with general medicine teams and approve inpatient medication orders. They will be given full access to the Synapse Medicine medication decision support platform.

Other: Synapse medicine platform

Pharmacist team pre-intervention

NO INTERVENTION

Pre-intervention, the inpatient pharmacists will round with general medicine teams and approve inpatient medication orders under conditions of usual care. They will base their recommendations on their knowledge and training and any tools (electronic or otherwise) that they choose to use.

Interventions

Synapse medicine platform OTHER

Intervention is the Synapse medicine platform for inpatient pharmacists. This software analyzes drug-related risks based on each patient's clinical characteristics

Pharmacist team post-intervention

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• any patient that the inpatient pharmacists care for on the inpatient medical team they round with

You may not qualify if:

• N/A

Sponsors & Collaborators

• Brigham and Women's Hospital: lead
• Synapse Medicine: collaborator
• Vanderbilt University Medical Center: collaborator

MeSH Terms

Conditions

Infections; Heart Diseases; Lung Diseases; Kidney Diseases; Liver Diseases; Gastrointestinal Diseases

Condition Hierarchy (Ancestors)

Cardiovascular Diseases; Respiratory Tract Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases; Digestive System Diseases

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor of Medicine

Model Details: Prospective pre-post mixed methods hybrid type 2 effectiveness-implementation study

Study Record Dates

• First Submitted: July 7, 2022
• First Posted: July 14, 2022
• Study Start: March 1, 2023
• Primary Completion: September 1, 2023
• Study Completion: December 1, 2023
• Last Updated: February 8, 2023

Record last verified: 2023-02