Helping hospitalized older adults with diabetes, hypertension, and multiple conditions get more individualized medication decisions
Optimizing Prescribing Decisions for Hospitalized Older Adults With Chronic Conditions: Aim 3
This pilot will test whether giving hospital clinicians a clinical decision framework helps them make more individualized and easier-to-understand medication decisions for patients 65 and older with chronic conditions like diabetes and hypertension.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 150 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | University of Pittsburgh Academic / other |
| Locations | 1 site (Pittsburgh, Pennsylvania) |
| Trial ID | NCT06605807 on ClinicalTrials.gov |
What this trial studies
This pilot enrolls attending clinicians on general medicine and hospital medicine services at UPMC Pittsburgh hospitals and their hospitalized patients aged 65+ who are discharged home with at least one cardiometabolic medication change. Clinicians attend an educational session introducing a clinical decision framework, and researchers compare clinician survey responses and prescribing records from before and after the session. The study also collects patient-reported measures of understanding about medication changes after discharge. The goal is to see whether clinician exposure to the framework increases confidence, reduces unnecessary medication changes at discharge, and improves patient comprehension.
Who should consider this trial
Good fit: Ideal participants are hospitalized adults aged 65 or older who are cared for by participating UPMC general medicine clinicians, are discharged home, and have at least one cardiometabolic medication started, stopped, or changed at discharge.
Not a fit: Patients younger than 65, those not discharged home, those without cardiometabolic medication changes, or those treated outside the participating UPMC services are unlikely to benefit from this trial.
Why it matters
Potential benefit: If successful, the framework could reduce unnecessary medication changes at discharge and help older patients better understand and manage their chronic medications, potentially lowering medication-related harm.
How similar studies have performed: Previous clinician-facing deprescribing and decision-support interventions have shown mixed but promising results in improving prescribing appropriateness and patient understanding, though inpatient-focused frameworks remain less well studied.
Eligibility criteria
Show full inclusion / exclusion 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
Where this trial is running
Pittsburgh, Pennsylvania
- University of Pittsburgh — Pittsburgh, Pennsylvania, United States (Recruiting)
Study contacts
- Principal investigator: Timothy S Anderson, MD, MAS — University of Pittsburgh
- Study coordinator: Ella Hileman-Kaplan, BA
- Email: prescribingwiselylab@pitt.edu
- Phone: 206-733-0880
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.