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| ID | Type | Description | Link |
|---|---|---|---|
| R18HS028562 | U.S. AHRQ Grant/Contract | View source |
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| Name | Class |
|---|---|
| Agency for Healthcare Research and Quality (AHRQ) | FED |
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The researchers hypothesize that existing-prescription notifications directed to pharmacists are more likely to lead to a prescription change than existing-prescription notifications directed to prescribers. Furthermore, the researchers hypothesize that the availability of a pharmacist referral option is associated with a higher rate of prescription changes for initial-prescription alerts that are directed to the prescriber at the time of initial-prescribing errors.
Findings from this project will establish a framework for implementing prescriber-pharmacist collaboration for high risk medications, including anticoagulants
Please note that the 3rd and 4th outcome measures are conditional on the outcomes of the 1st and 2nd outcome measures respectively.
Please note that enrollment of 300 will provide sufficient power to study.
Study data was obtained through data downloads and not from individual participant interactions. Final data collection for all outcomes took place on Dec 15, 2024.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| New-prescription Alert / Existing-prescription notification to prescriber | Experimental |
| |
| New-prescription Alert w/ referral option/ Existing-prescription notification to prescriber | Experimental |
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| New-prescription Alert/ Existing-prescription notification to pharmacist | Experimental |
| |
| New-prescription Alert w/ referral option/ Existing-prescription notification to pharmacist | Experimental |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| New-prescription Alert | Behavioral | An enhanced drug alert notification in the Michigan Medicine electronic health record (EHR) that is tailored to the specific type of inappropriate Direct Oral Anticoagulant (DOAC) use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter a newly prescribed DOAC prescription. |
| Measure | Description | Time Frame |
|---|---|---|
| The Number (Proportion) of Notifications (in the Existing-prescription Notification Conditions) That Are Addressed Within 7 Days. | Existing-prescription notification conditions = Prescriber notification & Pharmacist notification The number of notifications (in the existing-prescription notification conditions) that are addressed within 7 days/ total number of notifications | Up to 7 days |
| Measure | Description | Time Frame |
|---|---|---|
| The Number (Proportion) of Alerts (in the Newly Prescribed DOAC Alert Conditions) That Are Addressed Within 7 Days. | Newly prescribed DOAC alert conditions= Medication alert & Medication alert + referral Data reported represents the number of alerts (in the newly prescribed DOAC alert conditions) that are addressed within 7 days/ total number of alerts | Up to 7 days |
| Measure | Description | Time Frame |
|---|---|---|
| Specific Prescription Related Adverse Events in Participants' Patients | Data was gathered from the patients of participants within 30 days of a notification being sent via post-hoc examination of electronic medical record data Clinical adverse events assessed will include major 21 and clinically-relevant non-major bleeding (CRNMB)22 events, as defined by the International Society on Thrombosis and Haemostasis (ISTH), new or recurrent VTE events, and stroke or systemic arterial embolic events. Each of these events will be captured using health informatics tools (described below) and independently adjudicated by two expert clinicians (one pharmacist, one prescriber) who meet once in Y1 and twice in Y2 to adjudicate any potential adverse events. We will use two Michigan Medicine-developed health informatics tools, DataDirect and EMERSE,23 to identify adverse events and capture clinical data (e.g., notes, labs, imaging, procedure reports) for adjudication. |
Prescribers:
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Geoffrey Barnes, MD | University of Michigan | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Michigan | Ann Arbor | Michigan | 48109 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41398697 | Derived | Barnes GD, Choi SY, Lanham MS, Dorsch MP, Errickson J, Fabbri M, Saraswat A, Seagull FJ, Smith SN. Implementing prescriber-pharmacist collaboration to improve evidence-based medication prescribing using asynchronous, non-interruptive electronic health record notifications. Implement Sci. 2025 Dec 15;21(1):15. doi: 10.1186/s13012-025-01478-9. | |
| 39514247 | Derived | Smith SN, Lanham MSM, Seagull FJ, Fabbri M, Dorsch MP, Jennings K, Barnes G. System-Wide, Electronic Health Record-Based Medication Alerts for Appropriate Prescribing of Direct Oral Anticoagulants: Pilot Randomized Controlled Trial. JMIR Form Res. 2024 Nov 8;8:e64674. doi: 10.2196/64674. |
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Assignment to conditions for alerts and notifications made upon first receiving either alert or notification. Receiving only alerts or only notifications de facto 'moves' participant to a new condition for only receiving alerts/only notifications. Similarly, if an alert/notification is deemed to not fit study criteria (e.g. if a patient hospitalized for any reason within 7 days of the alert), this may shift the participant's assignment as they no longer have both an alert and a notification.
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| ID | Title | Description |
|---|---|---|
| FG000 | New-prescription Alert / Existing-prescription Notification to Prescriber | New-prescription Alert: An enhanced drug alert notification in the Michigan Medicine electronic health record (EHR) that is tailored to the specific type of inappropriate Direct Oral Anticoagulant (DOAC) use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter a newly prescribed DOAC prescription. Existing-prescription notification to prescriber: Prescriber receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. Note: inclusion in this group is predicated on the prescriber receiving at least one notification and one alert that meet criteria for inclusion in analysis by the end of the trial period. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Allocation at Enrollment |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Aug 11, 2022 |
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| New-prescription Alert with referral option | Behavioral | An enhanced drug alert notification in the EHR that is tailored to the specific type of inappropriate DOAC use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter new DOAC prescription. This alert will ALSO include an option for referral to the anticoagulation clinic pharmacist for assistance. |
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| Existing-prescription notification to prescriber | Behavioral | Prescriber receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. |
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| Existing-prescription notification to pharmacist | Behavioral | Pharmacist receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. |
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| Change in Effect Size for the Existing-prescription Notification Over Time | Reported on at the institution level (not individual level). Existing-prescription notification conditions = Prescriber notification & Pharmacist notification The number of notifications (in the existing-prescription notification conditions) that are addressed within 7 days/ total number of notifications, shown over multiple time periods. This outcome measure analysis is based on the results of outcome #1. | Month 0 to 19 months |
| Change in Effect Size for the Initial Alert Over Time | Reported on at the institution level (not individual level). Newly prescribed DOAC alert condition= Medication alert & Medication alert + referral The number of new prescription alerts that are addressed within 7 days/ total number of alerts, shown over multiple time periods. This outcome measure analysis is based on the results of outcome #2. | Month 0 to 19 months |
| 30 days from alert or notification |
| 37189171 | Derived | Smith SN, Lanham M, Seagull FJ, Dorsch M, Errickson J, Barnes GD. Implementing pharmacist-prescriber collaboration to improve evidence-based anticoagulant use: a randomized trial. Implement Sci. 2023 May 15;18(1):16. doi: 10.1186/s13012-023-01273-4. |
| FG001 | New-prescription Alert w/ Referral Option/ Existing-prescription Notification to Prescriber | New-prescription Alert with referral option: An enhanced drug alert notification in the EHR that is tailored to the specific type of inappropriate DOAC use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter new DOAC prescription. This alert will ALSO include an option for referral to the anticoagulation clinic pharmacist for assistance. Existing-prescription notification to prescriber: Prescriber receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. Note: inclusion in this group is predicated on the prescriber receiving at least one notification and one alert that meet criteria for inclusion in analysis by the end of the trial period. |
| FG002 | New-prescription Alert/ Existing-prescription Notification to Pharmacist | New-prescription Alert: An enhanced drug alert notification in the Michigan Medicine electronic health record (EHR) that is tailored to the specific type of inappropriate Direct Oral Anticoagulant (DOAC) use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter a newly prescribed DOAC prescription. Existing-prescription notification to pharmacist: Pharmacist receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. Note: inclusion in this group is predicated on the prescriber receiving at least one notification and one alert that meet criteria for inclusion in analysis by the end of the trial period. |
| FG003 | New-prescription Alert w/ Referral Option/ Existing-prescription Notification to Pharmacist | New-prescription Alert with referral option: An enhanced drug alert notification in the EHR that is tailored to the specific type of inappropriate DOAC use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter new DOAC prescription. This alert will ALSO include an option for referral to the anticoagulation clinic pharmacist for assistance. Existing-prescription notification to pharmacist: Pharmacist receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. Note: inclusion in this group is predicated on the prescriber receiving at least one notification and one alert that meet criteria for inclusion in analysis by the end of the trial period. |
| FG004 | New-prescription Alert/No Notifications | New-prescription Alert/No Notifications: An enhanced drug alert notification in the Michigan Medicine electronic health record (EHR) that is tailored to the specific type of inappropriate Direct Oral Anticoagulant (DOAC) use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter a newly prescribed DOAC prescription. No Notifications: Prescribers had no prescriptions that triggered a notification during the study period. Note: inclusion in this group is predicated on the prescriber receiving at least one notification and one alert that meet criteria for inclusion in analysis by the end of the trial period. |
| FG005 | New-prescription Alert w/Referral Option/No Notifications | New-prescription Alert with referral option: An enhanced drug alert notification in the EHR that is tailored to the specific type of inappropriate DOAC use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter new DOAC prescription. This alert will ALSO include an option for referral to the anticoagulation clinic pharmacist for assistance. No Notifications: Prescribers had no prescriptions that triggered a notification during the study period. Note: inclusion in this group is predicated on the prescriber receiving at least one notification and one alert that meet criteria for inclusion in analysis by the end of the trial period. |
| FG006 | No New-prescription Alert/Existing-prescription Notification to Prescriber | No New-prescription Alert: Prescriber had no prescriptions that triggered an alert Existing-prescription notification to prescriber: Prescriber receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. Note: inclusion in this group is predicated on the prescriber receiving at least one notification and one alert that meet criteria for inclusion in analysis by the end of the trial period. |
| FG007 | No New-prescription Alert/Existing-prescription Notification to Pharmacist | No New-prescription Alert: Prescriber had no prescriptions that triggered an alert Existing-prescription notification to pharmacist: Pharmacist receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. Note: inclusion in this group is predicated on the prescriber receiving at least one notification and one alert that meet criteria for inclusion in analysis by the end of the trial period. |
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| Post Analysis of Alerts/Notifications |
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| ID | Title | Description |
|---|---|---|
| BG000 | New-prescription Alert / Existing-prescription Notification to Prescriber | New-prescription Alert: An enhanced drug alert notification in the Michigan Medicine electronic health record (EHR) that is tailored to the specific type of inappropriate Direct Oral Anticoagulant (DOAC) use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter a newly prescribed DOAC prescription. Existing-prescription notification to prescriber: Prescriber receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. |
| BG001 | New-prescription Alert w/ Referral Option/ Existing-prescription Notification to Prescriber | New-prescription Alert with referral option: An enhanced drug alert notification in the EHR that is tailored to the specific type of inappropriate DOAC use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter new DOAC prescription. This alert will ALSO include an option for referral to the anticoagulation clinic pharmacist for assistance. Existing-prescription notification to prescriber: Prescriber receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. |
| BG002 | New-prescription Alert/ Existing-prescription Notification to Pharmacist | New-prescription Alert: An enhanced drug alert notification in the Michigan Medicine electronic health record (EHR) that is tailored to the specific type of inappropriate Direct Oral Anticoagulant (DOAC) use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter a newly prescribed DOAC prescription. Existing-prescription notification to pharmacist: Pharmacist receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. |
| BG003 | New-prescription Alert w/ Referral Option/ Existing-prescription Notification to Pharmacist | New-prescription Alert with referral option: An enhanced drug alert notification in the EHR that is tailored to the specific type of inappropriate DOAC use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter new DOAC prescription. This alert will ALSO include an option for referral to the anticoagulation clinic pharmacist for assistance. Existing-prescription notification to pharmacist: Pharmacist receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. |
| BG004 | New-prescription Alert/No Notifications | New-prescription Alert/No Notifications: An enhanced drug alert notification in the Michigan Medicine electronic health record (EHR) that is tailored to the specific type of inappropriate Direct Oral Anticoagulant (DOAC) use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter a newly prescribed DOAC prescription. No Notifications: Prescribers had no prescriptions that triggered a notification during the study period. |
| BG005 | New-prescription Alert w/Referral Option/No Notifications | New-prescription Alert with referral option: An enhanced drug alert notification in the EHR that is tailored to the specific type of inappropriate DOAC use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter new DOAC prescription. This alert will ALSO include an option for referral to the anticoagulation clinic pharmacist for assistance. No Notifications: Prescribers had no prescriptions that triggered a notification during the study period. |
| BG006 | No New-prescription Alert/Existing-prescription Notification to Prescriber | No New-prescription Alert: Prescriber had no prescriptions that triggered an alert Existing-prescription notification to prescriber: Prescriber receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. |
| BG007 | No New-prescription Alert/Existing-prescription Notification to Pharmacist | No New-prescription Alert: Prescriber had no prescriptions that triggered an alert Existing-prescription notification to pharmacist: Pharmacist receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. |
| BG008 | Total | Total of all reporting groups |
| Units | Counts |
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| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Customized | Count of Participants | Participants |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race and Ethnicity Not Collected | Race and Ethnicity were not collected from any participant. | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Clinical Role | Count of Participants | Participants |
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| 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 | |||||||||||||||||||||||
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| Primary | The Number (Proportion) of Notifications (in the Existing-prescription Notification Conditions) That Are Addressed Within 7 Days. | Existing-prescription notification conditions = Prescriber notification & Pharmacist notification The number of notifications (in the existing-prescription notification conditions) that are addressed within 7 days/ total number of notifications | Participants analyzed for this outcome all received an existing prescription notification (randomized to prescriber vs pharmacist recipient), regardless of if that participant was exposed to a new medication alert. | Posted | Number | percent of notifications | Up to 7 days |
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| Secondary | The Number (Proportion) of Alerts (in the Newly Prescribed DOAC Alert Conditions) That Are Addressed Within 7 Days. | Newly prescribed DOAC alert conditions= Medication alert & Medication alert + referral Data reported represents the number of alerts (in the newly prescribed DOAC alert conditions) that are addressed within 7 days/ total number of alerts | Participants analyzed for this outcome all received a new prescription alert (randomized to include or not include a pharmacist referral option), regardless of if that participant was exposed to an existing prescription notification. | Posted | Number | percentage of alerts | Up to 7 days |
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| Secondary | Change in Effect Size for the Existing-prescription Notification Over Time | Reported on at the institution level (not individual level). Existing-prescription notification conditions = Prescriber notification & Pharmacist notification The number of notifications (in the existing-prescription notification conditions) that are addressed within 7 days/ total number of notifications, shown over multiple time periods. This outcome measure analysis is based on the results of outcome #1. | Posted | Number | percent of notifications | Month 0 to 19 months |
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| Secondary | Change in Effect Size for the Initial Alert Over Time | Reported on at the institution level (not individual level). Newly prescribed DOAC alert condition= Medication alert & Medication alert + referral The number of new prescription alerts that are addressed within 7 days/ total number of alerts, shown over multiple time periods. This outcome measure analysis is based on the results of outcome #2. | Out of 255 participants who received alerts, 13 participants' data was determined to be ineligible | Posted | Number | percentage of alerts | Month 0 to 19 months |
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| Other Pre-specified | Specific Prescription Related Adverse Events in Participants' Patients | Data was gathered from the patients of participants within 30 days of a notification being sent via post-hoc examination of electronic medical record data Clinical adverse events assessed will include major 21 and clinically-relevant non-major bleeding (CRNMB)22 events, as defined by the International Society on Thrombosis and Haemostasis (ISTH), new or recurrent VTE events, and stroke or systemic arterial embolic events. Each of these events will be captured using health informatics tools (described below) and independently adjudicated by two expert clinicians (one pharmacist, one prescriber) who meet once in Y1 and twice in Y2 to adjudicate any potential adverse events. We will use two Michigan Medicine-developed health informatics tools, DataDirect and EMERSE,23 to identify adverse events and capture clinical data (e.g., notes, labs, imaging, procedure reports) for adjudication. | Not Posted | 30 days from alert or notification | Participants |
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No adverse event data was collected for the participants of the study, who were prescribers. While AE data for participants' patients was an exploratory outcome, the patients of the prescriber participants were not considered to be enrolled in this study. Since adverse event data was not collected for the participants of this study, there is no AE data to report here.
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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 | New-prescription Alert / Existing-prescription Notification to Prescriber | New-prescription Alert: An enhanced drug alert notification in the Michigan Medicine electronic health record (EHR) that is tailored to the specific type of inappropriate Direct Oral Anticoagulant (DOAC) use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter a newly prescribed DOAC prescription. Existing-prescription notification to prescriber: Prescriber receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. Note: inclusion in this group is predicated on the prescriber receiving at least one notification and one alert that meet criteria for inclusion in analysis by the end of the trial period." | 0 | 0 | 0 | 0 | 0 | 0 |
| EG001 | New-prescription Alert w/ Referral Option/ Existing-prescription Notification to Prescriber | New-prescription Alert with referral option: An enhanced drug alert notification in the EHR that is tailored to the specific type of inappropriate DOAC use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter new DOAC prescription. This alert will ALSO include an option for referral to the anticoagulation clinic pharmacist for assistance. Existing-prescription notification to prescriber: Prescriber receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. Note: inclusion in this group is predicated on the prescriber receiving at least one notification and one alert that meet criteria for inclusion in analysis by the end of the trial period." | 0 | 0 | 0 | 0 | 0 | 0 |
| EG002 | New-prescription Alert/ Existing-prescription Notification to Pharmacist | New-prescription Alert: An enhanced drug alert notification in the Michigan Medicine electronic health record (EHR) that is tailored to the specific type of inappropriate Direct Oral Anticoagulant (DOAC) use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter a newly prescribed DOAC prescription. Existing-prescription notification to pharmacist: Pharmacist receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. Note: inclusion in this group is predicated on the prescriber receiving at least one notification and one alert that meet criteria for inclusion in analysis by the end of the trial period." | 0 | 0 | 0 | 0 | 0 | 0 |
| EG003 | New-prescription Alert w/ Referral Option/ Existing-prescription Notification to Pharmacist | New-prescription Alert with referral option: An enhanced drug alert notification in the EHR that is tailored to the specific type of inappropriate DOAC use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter new DOAC prescription. This alert will ALSO include an option for referral to the anticoagulation clinic pharmacist for assistance. Existing-prescription notification to pharmacist: Pharmacist receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. Note: inclusion in this group is predicated on the prescriber receiving at least one notification and one alert that meet criteria for inclusion in analysis by the end of the trial period." | 0 | 0 | 0 | 0 | 0 | 0 |
| EG004 | New-prescription Alert/No Notifications | New-prescription Alert/No Notifications: An enhanced drug alert notification in the Michigan Medicine electronic health record (EHR) that is tailored to the specific type of inappropriate Direct Oral Anticoagulant (DOAC) use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter a newly prescribed DOAC prescription. No Notifications: Prescribers had no prescriptions that triggered a notification during the study period. Note: inclusion in this group is predicated on the prescriber receiving at least one notification and one alert that meet criteria for inclusion in analysis by the end of the trial period." | 0 | 0 | 0 | 0 | 0 | 0 |
| EG005 | New-prescription Alert w/Referral Option/No Notifications | New-prescription Alert with referral option: An enhanced drug alert notification in the EHR that is tailored to the specific type of inappropriate DOAC use (e.g., dosing too high for renal dysfunction) and offers decision support to the prescriber to alter new DOAC prescription. This alert will ALSO include an option for referral to the anticoagulation clinic pharmacist for assistance. No Notifications: Prescribers had no prescriptions that triggered a notification during the study period. Note: inclusion in this group is predicated on the prescriber receiving at least one notification and one alert that meet criteria for inclusion in analysis by the end of the trial period." | 0 | 0 | 0 | 0 | 0 | 0 |
| EG006 | No New-prescription Alert/Existing-prescription Notification to Prescriber | No New-prescription Alert: Prescriber had no prescriptions that triggered an alert Existing-prescription notification to prescriber: Prescriber receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. Note: inclusion in this group is predicated on the prescriber receiving at least one notification and one alert that meet criteria for inclusion in analysis by the end of the trial period." | 0 | 0 | 0 | 0 | 0 | 0 |
| EG007 | No New-prescription Alert/Existing-prescription Notification to Pharmacist | No New-prescription Alert: Prescriber had no prescriptions that triggered an alert Existing-prescription notification to pharmacist: Pharmacist receives a notification through the EHR indicating an existing DOAC prescription may not be appropriate (e.g. due to renal function change, new drug-drug interactions), and recommending a prescription update. Note: inclusion in this group is predicated on the prescriber receiving at least one notification and one alert that meet criteria for inclusion in analysis by the end of the trial period." | 0 | 0 | 0 | 0 | 0 | 0 |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Geoffrey Barnes, MD, MSc | University of Michigan | 888-287-1082 | gbarnes@med.umich.edu |
| Dec 12, 2025 |
| Prot_SAP_000.pdf |
| ID | Term |
|---|---|
| D011655 | Pulmonary Embolism |
| D054556 | Venous Thromboembolism |
| D001281 | Atrial Fibrillation |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D004617 | Embolism |
| D016769 | Embolism and Thrombosis |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D013923 | Thromboembolism |
| D001145 | Arrhythmias, Cardiac |
| D006331 | Heart Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Primary Care Clinician |
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| Specialty Care Clinician |
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