Care Planning for Older Persons With Multiple Conditions: Encouraging a Tailored Approach (COMET): Stage II

Yale University

Status: Completed

Conditions: Polypharmacy

Treatments: Other: COMET

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT02501967

1410014812

Details and patient eligibility

About

The purpose of the proposed project is to pilot-test in the clinic setting a computer-based clinical decision support system (CDSS) designed to optimize medication prescribing for older persons with multiple chronic conditions and polypharmacy.

Enrollment: 128 patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Veterans age 65 years and older.
• Patients should be diagnosed with diabetes and hypertension and be prescribed five or more medications.
• Patients receiving primary care at the West Haven campus of VA Connecticut Healthcare System.

Exclusion criteria

• Unable to manage own medications because of cognitive impairment.
• Medications prescribed by physician outside of the VA.
• Severe vision or hearing impairment.

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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128 participants in 2 patient groups

COMET

Experimental group

Description:

The intervention consists of completion of the tool (COMET) by means of a 30 minute telephone interview prior to the primary care visit and provision of the tool's output to the patient and primary care physician. The COMET tool takes information about the patient's medications and chronic conditions from the electronic health record, and then supplements this with information obtained by a telephone interview assessing the patient's cognition, social supports, medication adherence, home medication regimen, medication side effects, and health status. In addition, there is a chart review screen to record renal function, blood pressure, and hemoglobin A1C. All of this information is run through a set of algorithms to identify medication reconciliation errors and potentially inappropriate medications.

Treatment:

Other: COMET

Usual Care

No Intervention group