Grant: Catalyst Grant: eHealth Innovations - Aging

Adverse drug events are a leading cause of preventable harm to patients. The impact is higher in seniors who are often on more medications. Several rule sets have been developed to help reduce inappropriate prescribing. STOPP is one evidence-based rule set to aid prescribers in avoiding medications that can cause harm in patients 65+. Computer-based clinical decision support (CDS) can be an effective way to help apply evidence, such as STOPP, at the point of care. Helping prescribers avoid potentially inappropriate prescribing is one way to avoid adverse events, improve quality, and reduce costs. This mixed methods study seeks to assess and understand the impact of using an advanced CDS tool to present the STOPP criteria to support prescribers at the point of decision-making. We ask the overarching question: How can clinical decision support tools effectively translate a complex set of evidence-based rules into primary care clinical practice? The work is divided into 3 phases. PHASE 0: Focuses on designing an electronic CDS tool to reduce potentially inappropriate prescribing. We employ a user centred method to design a CDS tool based on the STOPP rules to help primary care prescribers. This is already funded and underway. PHASE 1: Through funding from this catalyst grant, we will build on Phase 0 with a randomized control trial. We will measure change in potentially inappropriate prescribing (as defined by STOPP criteria) by primary care prescribers (e.g. family doctors) who are using the CDS tool from Phase 0, as compared to those who are not. We will leverage the UBC primary care research network to efficiently measure prescribing changes related to the STOPP criteria. PHASE 2: As part of this grant, we will then complete a qualitative follow up with participants to aid in understanding how primary care prescribers perceived the CDS. This will help explain Phase 1 findings and provide additional information to enhance future decision support tools.