Optimizing Prescribing Decisions for Hospitalized Older Adults With Chronic Conditions

NCT06605807 | Recruiting

• 2 other identifiers: STUDY24070027K76AG074878
• Study Type: interventional
• Target: 150
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this pilot clinical trial is to learn if providing a clinical decision framework for managing older adults chronic conditions during hospitalization to inpatient clinicians improves clinicians' ability to individualize chronic condition prescribing decisions for hospitalized older adults (65 and older). The main questions it aims to answer are:

• Will the clinical decision framework lead to clinicians having greater confidence to individualize discharge prescribing?
• Will clinicians using the framework discharge make fewer changes to hospitalized older adults with home diabetes and hypertension medications than they did prior to receiving the framework?
• Will older adult patients of participating clinicians will report fewer gaps in understanding of medication changes after the clinician is exposed to the framework? Researchers will compare participating clinician survey responses and prescribing records from before and after an educational session presenting the clinical decision framework. Participants will be asked to
• Attend a one-time educational session on the clinical decision framework
• Complete 2 electronic surveys, one before and one following the educational session.
• Agree for researchers to contact their patients, in order for patients to complete a one-time phone survey about changes made to home medications during hospitalization and quality of communication from the hospital team.

Conditions

Prescribing Decisions; Diabetes; Multimorbidity; Hypertension; Geriatrics

Keywords

prescribing; hypertension; diabetes; geriatrics; polypharmacy; multimorbidity; hospital medicine

Outcome Measures

Primary Outcomes (1)

• Clinician - Change in Prescribing Self-Efficacy

  For each clinician participant the investigators will ask their self-efficacy to individualize blood pressure and diabetes treatment decisions for hospitalized older adults. Measured through ten 7-point Likert scale questions measured \[Strongly Disagree - Strongly Agree\]. Scores will be summed and range from 10 (all Strongly Disagree) to 70 (all Strongly Agree).

  Baseline and three months post-intervention

Secondary Outcomes (12)

• Clinician - Change in Attitudes

  Baseline and three months post-intervention

• Clinician - Discharge Prescribing

  Pre-intervention and post-intervention (2 months before and 3 months after the intervention)

• Patient - Change in Medication Discrepencies

  Single time survey within a week of discharge from clinician participants care.

• Clinician - Acceptability of Clinical Decision Framework

  3 months post-intervention

• Clinician - Change in Intentions

  Baseline and three months post-intervention

Study Arms (1)

Clinician Participants

EXPERIMENTAL

All clinician participants will undergo the same intervention, an educational session providing a clinical decision framework for managing older adults' chronic conditions during hospitalization.

Other: Clinical Decision Framework for Managing older adults' chronic conditions during hospitalization.

Interventions

Clinical Decision Framework for Managing older adults' chronic conditions during hospitalization. OTHER

All clinicians will attend an educational session where they will be provided a clinical decision framework for management of chronic conditions in hospitalized older adults, reviewing guiding principles for managing chronic disease in the hospital, and working through case-based hypothetical examples.

Clinician Participants

Eligibility Criteria

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

You may qualify if:

• Attending clinicians who practice on the general medicine or hospital medicine service at UPMC Presbyterian, UPMC Montefiore, UPMC Shadyside, UPMC Mercy, or UPMC Magee-Women's Hospital campuses.
• Practicing on the general medicine or hospital medicine service. This population may include physicians with training in general internal medicine, hospital medicine, family practice, internal medicine subspecialities, as well as advance practice clinicians.

You may not qualify if:

• Anticipating leaving current clinical position within next 3 months
• Less than 4 weeks of inpatient attending service scheduled within 3 months of recruitment
• Patient Participants:
• Adult aged 65 years or older who are hospitalized under the care of a participating clinician and discharged home.
• Eligible patients must recieve at least one cardiometabolic medication change at hospital discharge (can include new medication starts, stops, or dose changes). Cardiometabolic medications include any class of antihypertensive, lipid lowering, anti-platelet, or glucose lowering medications regardless of indication for use.
• Incapacity for informed consent / unable to answer survey questions due to cognitive impairment
• Enrolled in hospice care

Sponsors & Collaborators

• University of Pittsburgh: lead
• National Institute on Aging (NIA): collaborator

Study Sites (1)

University of Pittsburgh

Pittsburgh, Pennsylvania, 15213, United States

RECRUITING

MeSH Terms

Conditions

Diabetes Mellitus; Hypertension

Condition Hierarchy (Ancestors)

Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases; Vascular Diseases; Cardiovascular Diseases

Study Officials

• Timothy S Anderson, MD, MAS

  University of Pittsburgh

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Ella Hileman-Kaplan, BA

CONTACT

206-733-0880; prescribingwiselylab@pitt.edu

Study Design

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

Study Record Dates

• First Submitted: September 13, 2024
• First Posted: September 20, 2024
• Study Start: November 13, 2025
• Primary Completion (Estimated): October 30, 2026
• Study Completion (Estimated): January 30, 2027
• Last Updated: April 14, 2026

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)