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| Name | Class |
|---|---|
| University of Cincinnati | OTHER |
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Medication safety is an important concern in hospital Emergency Departments (EDs), which provide approximately 136 million patient visits annually in the US. An accurate list of the patient's medications is often needed to inform medical decision-making. Moreover, health care facilities are required to provide patients with an accurate, reconciled list of their medications upon completion of the visit. However, for 37-87% of patients in the ED, errors are present in the documented medication list, and patients often leave without an updated list of their medications or a good understanding of their self-care instructions. This increases the risk of harmful adverse drug events. Health disparity populations, who are more likely to seek care in EDs and who more often have difficulty providing a complete medication history, are disproportionately affected.
Health information technology has the potential to improve medication safety in this setting. PictureRx is an internet-based platform designed to improve medication management in vulnerable populations. It allows users to generate illustrated medication lists in an easily-understood, patient-centered format, in either English or Spanish. The investigators have developed a process for importing prescription fill data from the Surescripts Medication History service, which covers 96% of US pharmacies, into the PictureRx platform. The investigators are developing a mobile tablet PC-based medication history platform that receives and processes the Surescripts data, as well as prompts verification and additional information about the medication regimen.
This trial will assess the effect of the PictureRx medication history platform on the accuracy and efficiency of the medication reconciliation process, as well as patient understanding and satisfaction, in hospital Emergency Departments.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PictureRx | Experimental | PictureRx medication history platform |
|
| Usual care | No Intervention | Usual medication history process |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PictureRx medication history platform | Other | Tablet PC-based tool to take more complete and accurate medication history |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Changes/Updates in Medication List | Participants for whom nurses made updates or corrections to the medication history in electronic health record | 1 day |
| Measure | Description | Time Frame |
|---|---|---|
| Patient Understanding | Assessment of patient understanding of their medication regimen using 4 questions:
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Dane Boyington, Ph.D. | PictureRx, LLC | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Cincinnatti | Cincinnati | Ohio | 45267 | United States |
A total of 250 patients were enrolled into the intervention group. However, only 244 patients could be matched to suitable controls, and 6 were therefore excluded from the analysis of results. Thus the number of patients recruited was 494 (250 intervention + 244 control), but results are presented for 488 (244 intervention + 244 control).
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| ID | Title | Description |
|---|---|---|
| FG000 | PictureRx | Participants in the intervention group interacted with the PictureRx medication history platform on a tablet computer to provide information about their medications and verify their list of prescribed medications |
| FG001 | Usual Care | Patients in the usual care group were matched on a 1:1 basis with intervention patients, on the basis of having received care in the same area of the Emergency Department by the same nurse. Their medication information was collected in the usual fashion by interview. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | PictureRx | Participants in the intervention group interacted with the PictureRx medication history platform on a tablet computer to provide information about their medications and verify their list of prescribed medications |
| BG001 | Usual Care |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Participants With Changes/Updates in Medication List | Participants for whom nurses made updates or corrections to the medication history in electronic health record | Posted | Count of Participants | Participants | 1 day |
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | PictureRx | Participants in the intervention group interacted with the PictureRx medication history platform on a tablet computer to provide information about their medications and verify their list of prescribed medications |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Dane Boyington | SAI Interactive | (423) 521-2309 | dane@thinkingmedia.com |
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| 1 week |
Patients in the usual care group were matched on a 1:1 basis with intervention patients, on the basis of having received care in the same area of the Emergency Department by the same nurse. Their medication information was collected in the usual fashion by interview. |
| BG002 | Total | Total of all reporting groups |
| years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race/Ethnicity, Customized | Count of Participants | Participants |
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| Region of Enrollment | Count of Participants | Participants |
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| ESI acuity level | The Emergency Severity Index (ESI) is a widely-used triage tool, which Emergency Department nurses use to rate patient acuity and resource needs (range 1-5). Briefly, level 1 patients require immediate life-saving intervention. Level 2 are high-risk, have altered mental status, are in severe pain/distress, or may have certain vital sign abnormalities. Level 3 require many resources. Level 4 require one resource. Level 5 require no additional resources. (See www.esitriage.org for more information.) | Count of Participants | Participants |
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| Units |
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| Counts |
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| Participants |
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| Secondary | Patient Understanding | Assessment of patient understanding of their medication regimen using 4 questions:
| A convenience sample of 50 intervention patients was contacted by phone approximately 1 week after Emergency Department discharge to rate their understanding of their medication regimen. | Posted | Count of Participants | Participants | 1 week |
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| 0 |
| 244 |
| 0 |
| 244 |
| EG001 | Usual Care | Patients in the usual care group were matched on a 1:1 basis with intervention patients, on the basis of having received care in the same area of the Emergency Department by the same nurse. Their medication information was collected in the usual fashion by interview. | 0 | 244 | 0 | 244 |
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| Agree |
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| Strongly Agree |
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