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AgingEQUIPPEDNCT04004936

Reducing Potentially Inappropriate Medication Prescribing for Older Patients in the ED

A study testing EQUIPPED with Active Feedback and EQUIPPED with Passive Feedback in people with Aging, run by VA Office of Research and Development at 4 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This research is being conducted to learn which implementation strategy of EQUIPPED is most effective to improve prescribing practices of ED providers toward older Veterans and determine the factors influencing implementation of this program to reduce the prescribing of PIMs to older adults upon discharge from the ED. Read more about this study

Who is it for?
Any age
Conditions the study is for
Aging
What is being tested?
EQUIPPED with Active Feedback and EQUIPPED with Passive Feedback
Could I receive a placebo?
No, everyone receives an active treatment
How many people
74 participants
Where
4 sitesUnited States
Study dates
1 Oct 2019to 31 Dec 2024
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Prescribers at VA Medical Centers that are implementing EQUIPPED
  • Members of the EQUIPPED implementation team at enrolled sites

Who cannot join

  • Providers at VA Medical Centers that are not part of the upcoming EQUIPPED implementation trial.

Trial locations and contacts

4 sites in 1 country.

United States4 sites

  • Birmingham VA Medical Center, Birmingham, AL

    Birmingham, Alabama, 35233-1927

  • Atlanta VA Medical and Rehab Center, Decatur, GA

    Decatur, Georgia, 30033-4004

  • Durham VA Medical Center, Durham, NC

    Durham, North Carolina, 27705-3875

  • VA Salt Lake City Health Care System, Salt Lake City, UT

    Salt Lake City, Utah, 84148-0001

Other trials in United States

About this study

Official title: Reducing Potentially Inappropriate Medication Prescribing for Older Patients: Enhancing Quality of Provider Practices for Older Adults in the Emergency Department (EQUIPPED)

This research is being conducted to learn which implementation strategy of EQUIPPED is most effective to improve prescribing practices of ED providers toward older Veterans and determine the factors influencing implementation of this program to reduce the prescribing of PIMs to older adults upon discharge from the ED. The study has three research aims. The procedures for these research aims are described below:

  • Aim 1 - Examining the Impact of Passive Provider Feedback vs. Active Provider Feedback Through a Randomized Trial
  • Aim 2 - Determination of Factors Affecting Organizational Adoption of EQUIPPED
  • Aim 3 - Micro-Costing the Active and Passive Feedback Versions of the EQUIPPED Intervention
Read the detailed description

Enhancing Quality of Prescribing Practices for Older Adults Discharged from the Emergency Department (EQUIPPED is a multi-component program to reduce the prescribing of potentially inappropriate medications (PIMs) to older adults upon discharge from the Emergency Department (ED). It has three core components: 1) provider education, 2) Electronic Health Record (EHR)-based clinical decision support (CDS) including pharmacy quick order sets to facilitate provider order entry, and 3) provider audit and feedback with peer benchmarking. In order to inform a Veterans Affairs (VA) system-wide approach to improve prescribing safety for older Veterans, the investigators will conduct a study to determine best practices for influencing provider prescribing behavior in order to decrease PIMs prescribed for older Veterans at the time of ED discharge. The overall goal of this project is to determine which EQUIPPED implementation strategy (active or passive feedback) is most effective to reduce prescribing of PIMs for older Veterans discharged from the ED.

Conditions
Aging
Being tested
EQUIPPED with Active Feedback, EQUIPPED with Passive Feedback
Keywords
Emergency Department, Potentially Inappropriate Medications, Inappropriate Prescribing, Quality Improvement, Veteran Health, Older Adults
Medical subject headings
Emergencies

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • EQUIPPED with Active FeedbackOther

    Enhancing Quality of Prescribing Practices for Older Adults Discharged from the Emergency Department (EQUIPPED is a multi-component program to reduce the prescribing of potentially inappropriate medications (PIMs) to older adults upon discharge from the Emergency Department (ED). It has three core components: 1) provider education, 2) Electronic Health Record (EHR)-based clinical decision support (CDS) including pharmacy quick order sets to facilitate provider order entry, and 3) provider audit and feedback with peer benchmarking. The active feedback group will receive one-to-one (1:1) in-person academic detailing from a professional colleague that includes in-person audit, feedback, and peer benchmarking and provide on-site expertise.

  • EQUIPPED with Passive FeedbackOther

    Enhancing Quality of Prescribing Practices for Older Adults Discharged from the Emergency Department (EQUIPPED is a multi-component program to reduce the prescribing of potentially inappropriate medications (PIMs) to older adults upon discharge from the Emergency Department (ED). It has three core components: 1) provider education, 2) Electronic Health Record (EHR)-based clinical decision support (CDS) including pharmacy quick order sets to facilitate provider order entry, and 3) provider audit and feedback with peer benchmarking. The passive feedback group will receive monthly provider feedback via an electronic dashboard with audit, feedback and peer benchmarking.

Study groups in NCT04004936
Study groupRoleWhat they receive
Active FeedbackActive comparatorEQUIPPED with active provider feedback, implementing one-to-one (1:1) in-person academic detailing from a professional colleague that includes in-person audit, feedback, and peer benchmarking and provide on-site expertise.
Receives: Other: EQUIPPED with Active Feedback
Passive FeedbackActive comparatorEQUIPPED with passive provider feedback, implementing monthly provider feedback via an electronic dashboard with audit, feedback and peer benchmarking.
Receives: Other: EQUIPPED with Passive Feedback

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of PIMs Prescribed

    Percentage of prescriptions that are PIMS (potentially inappropriate medications) as defined according to the Beers criteria prescribed to adults aged 65 and older and discharged from the ED.

    Measured: 12-Months Post Implementation of EQUIPPED

Secondary outcomes (2)

  1. Social Cognitive Theory Survey - Perceived Control Domain

    Prescribers at participating EDs completed a survey at baseline, 6, and 12 months to assess perceived control related to prescribing as a factor that could be impacted by the EQUIPPED intervention. The outcome relates to the average reported perception of 'control' across site respondents by implementation group assignment.

    The 'perceived control' domain is assessed with a 1-5 Likert scale where 1=strongly disagree and 5=strongly agree with the statement, "I am in control of reducing the potentially inappropriate medications that I prescribe for older Veterans at the time of emergency department."

    Measured: 12-Months After the Delivery of the First EQUIPPED Report

  2. Micro-Costing the Active and Passive Feedback Versions of the EQUIPPED Intervention

    Micro-costing of the intervention will be done to learn details of specific factors that may impact the cost of the intervention to the Veterans Health Administration (organization)

    Measured: 12-Months Post Implementation of EQUIPPED

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Jul 2019
  2. Study start1 Oct 2019
  3. Primary completion31 Dec 2022
  4. Study completion31 Dec 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Randomised
Intervention model
Parallel groups
Model description
In order to inform a Veterans Affairs (VA) system-wide approach to improve prescribing safety for older Veterans, the investigators will conduct a randomized study to determine best practices for influencing provider prescribing behavior in order to decrease PIMs prescribed for older Veterans at the time of ED discharge. The overall goal of this project is to determine which EQUIPPED implementation strategy (active or passive feedback) is most effective to reduce prescribing of PIMs for older Veterans discharged from the ED. Eight sites will be randomized to either active feedback with individual, in-person academic detailing or passive feedback delivered via an individualized electronic dashboard.
Masking
None (open label)
Enrolment
74 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04004936
Sponsor's protocol ID
IIR 17-236
Other IDs
IIR HX00257-01A1
Acronym
EQUIPPED
Status last verified
Feb 2026
First submitted
28 Jun 2019
Last updated
25 Feb 2026
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: A de-identified, anonymized dataset will be created and shared.

Publications

  • Burningham Z, Jackson GL, Kelleher J, Stevens M, Morris I, Cohen J, Maloney G, Vaughan CP. The Enhancing Quality of Prescribing Practices for Older Veterans Discharged From the Emergency Department (EQUIPPED) Potentially Inappropriate Medication Dashboard: A Suitable Alternative to the In-person Academic Detailing and Standardized Feedback Reports of Traditional EQUIPPED? Clin Ther. 2020 Apr;42(4):573-582. doi: 10.1016/j.clinthera.2020.02.013. Epub 2020 Mar 25.

    PubMed 32222360

  • Burningham Z, Jackson GL, Kelleher JL, Morris I, Stevens MB, Cohen J, Maloney G, Sauer BC, Halwani AS, Chen W, Vaughan CP. Use of a Medication Safety Audit and Feedback Tool in the Emergency Department Is Affected by Prescribing Characteristics. Appl Clin Inform. 2023 Aug;14(4):684-692. doi: 10.1055/s-0043-1771393. Epub 2023 Aug 30.

    PubMed 37648222

  • Vaughan CP, Burningham Z, Kelleher JL, McGwin G, Jasien CL, Hastings SN, Stevens MB, Morris I, Jackson GL; The EQUIPPED VA Implementation QI Group. A cluster-randomized trial of two implementation strategies to deliver audit and feedback in the EQUIPPED medication safety program. Acad Emerg Med. 2023 Apr;30(4):340-348. doi: 10.1111/acem.14697. Epub 2023 Mar 8.

    PubMed 36790188

  • Lopez JCF, Morris IJ, Vaughan CP, Burningham ZR, Kelleher JL, Vandenberg AE, King HA, Hastings SN, Stevens MB, Jackson GL. Factors Affecting Implementation of the EQUIPPED Medication Safety Program for Older Veterans in the Emergency Department: A Qualitative Analysis. J Am Geriatr Soc. 2026 Jul 11. doi: 10.1111/jgs.70587. Online ahead of print.

    PubMed 42435322

Questions about this trial

What is this clinical trial studying?

A study testing EQUIPPED with Active Feedback and EQUIPPED with Passive Feedback in people with Aging, run by VA Office of Research and Development at 4 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 25 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 6 Aug 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of PIMs Prescribed (time frame: 12-Months Post Implementation of EQUIPPED). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04004936, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Feb 2026.

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