Optimizing Prescribing Decisions for Hospitalized Older Adults With Chronic Conditions

Launched by UNIVERSITY OF PITTSBURGH · Sep 17, 2024

Keywords

ClinConnect Summary

This clinical trial is focused on improving how doctors manage medications for older adults in the hospital, particularly those with ongoing health issues like diabetes and high blood pressure. The researchers want to see if providing doctors with a special decision-making guide will help them feel more confident when deciding on medication changes for patients aged 65 and older. They will look at whether this guide helps doctors make fewer changes to medications that patients were already taking at home and if patients feel they understand their medication changes better after leaving the hospital.

To participate, doctors must work at specific UPMC hospitals and have a certain amount of experience. Older patients who are being treated at these hospitals and have had changes made to their heart or blood sugar medications during their stay may also be eligible. Participants will attend a one-time educational session about the new decision-making framework and complete surveys before and after this session. Additionally, researchers will follow up with patients to gain feedback on their experience and understanding of any medication changes made during their hospital stay. This trial aims to enhance communication and care for older adults facing complex health challenges.

Gender

ALL

Eligibility criteria

• Clinician Participants:
• Inclusion Criteria:
• • 1. 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.
• • 2. 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.
• Exclusion Criteria:
• • 1. Anticipating leaving current clinical position within next 3 months
• • 2. Less than 4 weeks of inpatient attending service scheduled within 3 months of recruitment
• Patient Participants:
• Inclusion Criteria:
• • 1. Adult aged 65 years or older who are hospitalized under the care of a participating clinician and discharged home.
• • 2. 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.
• Exclusion Criteria:
• • 1. Incapacity for informed consent / unable to answer survey questions due to cognitive impairment
• • 2. Enrolled in hospice care