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Published in: Trials 1/2015

Open Access 01-12-2015 | Study protocol

MEDUCATE trial: effectiveness of an intensive EDUCATional intervention for IT-mediated MEDication management in the outpatient clinic – study protocol for a cluster randomized controlled trial

Authors: F. van Stiphout, J.E.F Zwart-van Rijkom, J.E.C.M. Aarts, H. Koffijberg, E. Klarenbeek-deJonge, M. Krulder, K.C.B. Roes, A.C.G. Egberts, E.W.M.T. ter Braak

Published in: Trials | Issue 1/2015

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Abstract

Background

Using information technology for medication management is an opportunity to help physicians to improve the quality of their documentation and communication and ultimately to improve patient care and patient safety. Physician education is necessary to take full advantage of information technology systems. In this trial, we seek to determine the effectiveness of an intensive educational intervention compared with the standard approach in improving information technology–mediated medication management and in reducing potential adverse drug events in the outpatient clinic.

Methods/Design

We are conducting a multicenter, cluster randomized controlled trial. The participants are specialists and residents working in the outpatient clinic of internal medicine, cardiology, pulmonology, geriatrics, gastroenterology and rheumatology. The intensive educational intervention is composed of a small-group session and e-learning. The primary outcome is discrepancies between registered medication (by physicians) and actually used medication (by patients). The key secondary outcomes are potential adverse events caused by missed drug–drug interactions. The primary and key secondary endpoints are being assessed shortly after the educational intervention is completed. Sample size will be calculated to ensure sufficient power. A sample size of 40 physicians per group and 20 patients per physician will ensure a power of >90 %, which means we will need a total of 80 physicians and 1,600 patients.

Discussion

We performed an exploratory trial wherein we tested the recruitment process, e-learning, time schedule, and methods for data collection, data management and data analysis. Accordingly, we refined the processes and content: the recruitment strategy was intensified, extra measures were taken to facilitate smooth conductance of the e-learning and parts were made optional. First versions of the procedures for data collection were determined. Data entry and analysis was further standardized by using the G-standard database in the telephone questionnaire.

Trial registration

ISRCTN registry: ISRCTN50890124. Registered 10 June 2013.
Literature
1.
go back to reference Gandhi TK, Weingart SN, Borus J, Seger AC, Peterson J, Burdick E, et al. Adverse drug events in ambulatory care. N Engl J Med. 2003;348:1556–64.CrossRefPubMed Gandhi TK, Weingart SN, Borus J, Seger AC, Peterson J, Burdick E, et al. Adverse drug events in ambulatory care. N Engl J Med. 2003;348:1556–64.CrossRefPubMed
4.
go back to reference Blumenthal D, Tavenner M. The “meaningful use” regulation for electronic health records. N Engl J Med. 2010;363:501–4.CrossRefPubMed Blumenthal D, Tavenner M. The “meaningful use” regulation for electronic health records. N Engl J Med. 2010;363:501–4.CrossRefPubMed
5.
go back to reference Drenth-van Maanen AC, Spee J, van Hensbergen L, Jansen PA, Egberts TC, van Marum RJ. Structured history taking of medication use reveals iatrogenic harm due to discrepancies in medication histories in hospital and pharmacy records. J Am Geriatr Soc. 2011;59:1976–7.CrossRefPubMed Drenth-van Maanen AC, Spee J, van Hensbergen L, Jansen PA, Egberts TC, van Marum RJ. Structured history taking of medication use reveals iatrogenic harm due to discrepancies in medication histories in hospital and pharmacy records. J Am Geriatr Soc. 2011;59:1976–7.CrossRefPubMed
6.
go back to reference Koppel R, Metlay JP, Cohen A, Abaluck B, Localio AR, Kimmel SE, et al. Role of computerized physician order entry systems in facilitating medication errors. JAMA. 2005;293:1197–203.CrossRefPubMed Koppel R, Metlay JP, Cohen A, Abaluck B, Localio AR, Kimmel SE, et al. Role of computerized physician order entry systems in facilitating medication errors. JAMA. 2005;293:1197–203.CrossRefPubMed
7.
go back to reference Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158:200–7.CrossRefPubMed Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158:200–7.CrossRefPubMed
8.
go back to reference Eldridge S, Kerry S. A practical guide to cluster randomised trials in health services research. Chichester, UK: John Wiley & Sons; 2012.CrossRef Eldridge S, Kerry S. A practical guide to cluster randomised trials in health services research. Chichester, UK: John Wiley & Sons; 2012.CrossRef
9.
go back to reference van der Sijs H, Bouamar R, van Gelder T, Aarts J, Berg M, Vulto A. Functionality test for drug safety alerting in computerized physician order entry systems. Int J Med Inform. 2010;79:243–51.CrossRefPubMed van der Sijs H, Bouamar R, van Gelder T, Aarts J, Berg M, Vulto A. Functionality test for drug safety alerting in computerized physician order entry systems. Int J Med Inform. 2010;79:243–51.CrossRefPubMed
10.
go back to reference van Merriënboer JJG, Kirschner PA. Ten steps to complex learning, a systematic approach to four-component instructional design. 2nd ed. New York: Taylor & Frances; 2013. van Merriënboer JJG, Kirschner PA. Ten steps to complex learning, a systematic approach to four-component instructional design. 2nd ed. New York: Taylor & Frances; 2013.
11.
go back to reference Grol R, Wensing M, editors. Implementatie: effectieve verbetering van de patiëntenzorg. Amsterdam: Reed Business/Elsevier Gezondheidszorg; 2006. Grol R, Wensing M, editors. Implementatie: effectieve verbetering van de patiëntenzorg. Amsterdam: Reed Business/Elsevier Gezondheidszorg; 2006.
15.
go back to reference van Roon EN, Flikweert S, le Comte M, Langendijk PN, Kwee-Zuiderwijk WJ, Smits P, et al. Clinical relevance of drug–drug interactions: a structured assessment procedure. Drug Saf. 2005;28:1131–9.CrossRefPubMed van Roon EN, Flikweert S, le Comte M, Langendijk PN, Kwee-Zuiderwijk WJ, Smits P, et al. Clinical relevance of drug–drug interactions: a structured assessment procedure. Drug Saf. 2005;28:1131–9.CrossRefPubMed
18.
go back to reference Schnipper JL, Hamann C, Ndumele CD, Liang CL, Carty MG, Karson AS, et al. Effect of an electronic medication reconciliation application and process redesign on potential adverse drug events: a cluster-randomized trial. Arch Intern Med. 2009;169:771–80.CrossRefPubMed Schnipper JL, Hamann C, Ndumele CD, Liang CL, Carty MG, Karson AS, et al. Effect of an electronic medication reconciliation application and process redesign on potential adverse drug events: a cluster-randomized trial. Arch Intern Med. 2009;169:771–80.CrossRefPubMed
19.
go back to reference Harrison MI, Koppel R, Bar-Lev S. Unintended consequences of information technologies in health care–an interactive sociotechnical analysis. J Am Med Inform Assoc. 2007;14:542–9.CrossRefPubMedPubMedCentral Harrison MI, Koppel R, Bar-Lev S. Unintended consequences of information technologies in health care–an interactive sociotechnical analysis. J Am Med Inform Assoc. 2007;14:542–9.CrossRefPubMedPubMedCentral
20.
go back to reference Linder JA, Rigotti NA, Schneider LI, Kelley JH, Brawarsky P, Schnipper JL, et al. Clinician characteristics and use of novel electronic health record functionality in primary care. J Am Med Inform Assoc. 2011;18 Suppl 1:i87–90.CrossRefPubMedPubMedCentral Linder JA, Rigotti NA, Schneider LI, Kelley JH, Brawarsky P, Schnipper JL, et al. Clinician characteristics and use of novel electronic health record functionality in primary care. J Am Med Inform Assoc. 2011;18 Suppl 1:i87–90.CrossRefPubMedPubMedCentral
21.
go back to reference Leendertse AJ, Egberts AC, Stoker LJ, van den Bemt PM, HARM Study Group. Frequency of and risk factors for preventable medication-related hospital admissions in the Netherlands. Arch Intern Med. 2008;168:1890–6.PubMed Leendertse AJ, Egberts AC, Stoker LJ, van den Bemt PM, HARM Study Group. Frequency of and risk factors for preventable medication-related hospital admissions in the Netherlands. Arch Intern Med. 2008;168:1890–6.PubMed
Metadata
Title
MEDUCATE trial: effectiveness of an intensive EDUCATional intervention for IT-mediated MEDication management in the outpatient clinic – study protocol for a cluster randomized controlled trial
Authors
F. van Stiphout
J.E.F Zwart-van Rijkom
J.E.C.M. Aarts
H. Koffijberg
E. Klarenbeek-deJonge
M. Krulder
K.C.B. Roes
A.C.G. Egberts
E.W.M.T. ter Braak
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Trials / Issue 1/2015
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-015-0744-8

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