Trial Outcomes & Findings for MIDAS Cluster Randomized Controlled Trial of Implementation Strategies to Optimize Use of Medications in VA Clinical Settings (NCT NCT05065502)
NCT ID: NCT05065502
Last Updated: 2025-10-15
Results Overview
Percentage of PIMs across AD vs. LEAP+AD facilities were modelled as the difference between post-period and pre-period, using the average from the 1-6-month pre-baseline period as "pre" and the average 13-18-month post-baseline as "post." Data was collected monthly at patient level and collapsed by clinic-month for patients who are at risk of potentially inappropriate medication use. Clinic-month outcome was computed as: 1) VIONE; proportion of patients who possessed one or more medications from the Beers' list of patients 65 or older, actively following with the clinic, and not in hospice/palliative care; 2) DOACs; proportion of patients with flags for potentially inappropriate use on a DOAC safety dashboard of those using DOACs; 3) CBTI; proportion of patients with a new prescription for a sleep medication for insomnia who have not had CBTI of those who are actively followed by the clinic and not in hospice/palliative care. The outcome was analyzed by pooling across all three-EBPs.
COMPLETED
NA
24 participants
13-18 months post-baseline
2025-10-15
Participant Flow
Unit of analysis: VA medical centers and/or clinics
Participant milestones
| Measure |
Academic Detailing (AD) Only
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
|
AD + LEAP Combined
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
LEAP: Sites also received the Learn. Engage. Act. Process. (LEAP) program, which is a 6-month quality improvement coaching program plus a 6-month follow-up.
|
|---|---|---|
|
Overall Study
STARTED
|
0 14
|
0 14
|
|
Overall Study
COMPLETED
|
0 12
|
0 12
|
|
Overall Study
NOT COMPLETED
|
0 2
|
0 2
|
Reasons for withdrawal
Withdrawal data not reported
Baseline Characteristics
The row population differs from the overall population because age was missing for some participants
Baseline characteristics by cohort
| Measure |
Academic Detailing (AD) Only
n=12 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
|
AD + LEAP Combined
n=12 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
LEAP: Sites also received the Learn. Engage. Act. Process. (LEAP) program, which is a 6-month quality improvement coaching program plus a 6-month follow-up.
|
Total
n=24 VA medical centers and/or clinics
Total of all reporting groups
|
|---|---|---|---|
|
Age, Continuous
|
66.7 years
STANDARD_DEVIATION 16.4 • n=79471 Participants • The row population differs from the overall population because age was missing for some participants
|
66.3 years
STANDARD_DEVIATION 15.9 • n=66204 Participants • The row population differs from the overall population because age was missing for some participants
|
66.5 years
STANDARD_DEVIATION 16.2 • n=145675 Participants • The row population differs from the overall population because age was missing for some participants
|
|
Sex: Female, Male
Female
|
5201 Participants
n=79471 Participants • The row population differs from the overall population because sex was missing for some participants
|
4162 Participants
n=66204 Participants • The row population differs from the overall population because sex was missing for some participants
|
9363 Participants
n=145675 Participants • The row population differs from the overall population because sex was missing for some participants
|
|
Sex: Female, Male
Male
|
74270 Participants
n=79471 Participants • The row population differs from the overall population because sex was missing for some participants
|
62042 Participants
n=66204 Participants • The row population differs from the overall population because sex was missing for some participants
|
136312 Participants
n=145675 Participants • The row population differs from the overall population because sex was missing for some participants
|
|
Ethnicity (NIH/OMB)
Hispanic or Latino
|
17593 Participants
n=79481 Participants
|
2078 Participants
n=66208 Participants
|
19671 Participants
n=145689 Participants
|
|
Ethnicity (NIH/OMB)
Not Hispanic or Latino
|
59993 Participants
n=79481 Participants
|
62991 Participants
n=66208 Participants
|
122984 Participants
n=145689 Participants
|
|
Ethnicity (NIH/OMB)
Unknown or Not Reported
|
1895 Participants
n=79481 Participants
|
1139 Participants
n=66208 Participants
|
3034 Participants
n=145689 Participants
|
|
Race/Ethnicity, Customized
White
|
61865 Participants
n=79481 Participants
|
51216 Participants
n=66208 Participants
|
113081 Participants
n=145689 Participants
|
|
Race/Ethnicity, Customized
Black
|
9278 Participants
n=79481 Participants
|
6142 Participants
n=66208 Participants
|
15420 Participants
n=145689 Participants
|
|
Race/Ethnicity, Customized
Asian
|
546 Participants
n=79481 Participants
|
1552 Participants
n=66208 Participants
|
2098 Participants
n=145689 Participants
|
|
Race/Ethnicity, Customized
Hawaiian-Pacific
|
527 Participants
n=79481 Participants
|
563 Participants
n=66208 Participants
|
1090 Participants
n=145689 Participants
|
|
Race/Ethnicity, Customized
Native-American/Alaskan Native
|
432 Participants
n=79481 Participants
|
746 Participants
n=66208 Participants
|
1178 Participants
n=145689 Participants
|
|
Race/Ethnicity, Customized
Missing
|
6833 Participants
n=79481 Participants
|
5989 Participants
n=66208 Participants
|
12822 Participants
n=145689 Participants
|
|
Percent of Patients with Overall Inappropriate Medications across trials and facilities at Baseline
|
12.7 Percent of patients with PIMs
STANDARD_DEVIATION 17.1 • n=12 VA medical centers and/or clinics
|
14.1 Percent of patients with PIMs
STANDARD_DEVIATION 19.1 • n=12 VA medical centers and/or clinics
|
13.4 Percent of patients with PIMs
STANDARD_DEVIATION 16.2 • n=24 VA medical centers and/or clinics
|
PRIMARY outcome
Timeframe: 13-18 months post-baselinePopulation: The number of participants analyzed refers to all individuals who were eligible for the cross sectional analysis at any time point in the study .
Percentage of PIMs across AD vs. LEAP+AD facilities were modelled as the difference between post-period and pre-period, using the average from the 1-6-month pre-baseline period as "pre" and the average 13-18-month post-baseline as "post." Data was collected monthly at patient level and collapsed by clinic-month for patients who are at risk of potentially inappropriate medication use. Clinic-month outcome was computed as: 1) VIONE; proportion of patients who possessed one or more medications from the Beers' list of patients 65 or older, actively following with the clinic, and not in hospice/palliative care; 2) DOACs; proportion of patients with flags for potentially inappropriate use on a DOAC safety dashboard of those using DOACs; 3) CBTI; proportion of patients with a new prescription for a sleep medication for insomnia who have not had CBTI of those who are actively followed by the clinic and not in hospice/palliative care. The outcome was analyzed by pooling across all three-EBPs.
Outcome measures
| Measure |
Academic Detailing (AD) Only
n=12 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
|
AD + LEAP Combined
n=12 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
LEAP: Sites also received the Learn. Engage. Act. Process. (LEAP) program, which is a 6-month quality improvement coaching program plus a 6-month follow-up.
|
|---|---|---|
|
Change in the Percentage of Patients With Potentially Inappropriate Medication Use (PIMs) Between Pre- and Post-periods, Across Facilities.
|
-0.133 percentage of patients with PIMs
Interval -0.481 to 0.2144
|
-0.395 percentage of patients with PIMs
Interval -0.8 to 0.0104
|
SECONDARY outcome
Timeframe: 13-18 months post-baselinePopulation: The number of participants refers to all individuals who were eligible for the cross sectional analysis at any time point in the VIONE study.
Medications include proton pump inhibitors (PPIs), aspirin, central nervous system (CNS) active medications (muscle relaxants, anti-psychotics, Z-drugs, and benzodiazepines), or anticholinergic drugs. This is the primary outcome for the VIONE trial when analyzed as a stand-alone trial and the VIONE sub-analysis of the overall MIDAS study primary outcome. Percentage of patients with PIMs across AD vs. LEAP+AD facilities were modelled longitudinally using Generalized Estimating Equations (GEE), with a three way-interaction of arm, month of follow-up, and pre-, post-period. Data will was be collected monthly at patient level and collapsed by clinic-month for patients who are at risk of potentially inappropriate medication use. Estimates computed using least squares (LS) means from the GEE model.
Outcome measures
| Measure |
Academic Detailing (AD) Only
n=6 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
|
AD + LEAP Combined
n=6 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
LEAP: Sites also received the Learn. Engage. Act. Process. (LEAP) program, which is a 6-month quality improvement coaching program plus a 6-month follow-up.
|
|---|---|---|
|
Change in Patients With Percentage of Potentially Inappropriate Use of Medications (PIMs) Across Facilities
|
-0.01756 percentage of patients with PIMs
Interval -0.03052 to -0.00459
|
-0.01618 percentage of patients with PIMs
Interval -0.03854 to 0.00619
|
SECONDARY outcome
Timeframe: 13-18 months post-baselinePopulation: The number of participants refers to all individuals who were eligible for the cross sectional analysis at any time point in the VIONE study.
Cost of all drugs without regard to appropriateness. Average monthly cost per patient across LEAP vs. LEAP + AD facilities were modelled longitudinally with a Generalized Linear Model with a Gamma Link and a three-way interaction of arm, month of follow-up and pre-, post-period. Estimates computed using LS means from the GEE model. This will be a secondary outcome for the VIONE trial when analyzed as a stand-alone trial.
Outcome measures
| Measure |
Academic Detailing (AD) Only
n=6 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
|
AD + LEAP Combined
n=6 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
LEAP: Sites also received the Learn. Engage. Act. Process. (LEAP) program, which is a 6-month quality improvement coaching program plus a 6-month follow-up.
|
|---|---|---|
|
Change in Monthly Medication Costs for All Drugs Across Facilities
|
70.73 dollars per patient
Interval 34.94 to 106.52
|
13.72 dollars per patient
Interval -29.76 to 57.19
|
SECONDARY outcome
Timeframe: 13-18 months post-baselinePopulation: The number of participants refers to all individuals who were eligible for the cross sectional analysis at any time point in the VIONE study.
Number of medication reviews completed by a pharmacist. This will be a secondary outcome for the VIONE trial when analyzed as a stand-alone trial.
Outcome measures
| Measure |
Academic Detailing (AD) Only
n=6 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
|
AD + LEAP Combined
n=6 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
LEAP: Sites also received the Learn. Engage. Act. Process. (LEAP) program, which is a 6-month quality improvement coaching program plus a 6-month follow-up.
|
|---|---|---|
|
Change in Number of Medication Reviews Across Facilities
|
-0.00004 number of medication reviews
Interval -0.00011 to 0.00002
|
-0.00064 number of medication reviews
Interval -0.00112 to -0.00017
|
SECONDARY outcome
Timeframe: 13-18 months post-baselinePopulation: The number of participants refers to all individuals who were eligible for the cross sectional analysis at any time point in the VIONE study.
This is a measure of count of medications used at the patient (not facility) level. This will be a secondary outcome for the VIONE trial when analyzed as a stand-alone trial.
Outcome measures
| Measure |
Academic Detailing (AD) Only
n=6 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
|
AD + LEAP Combined
n=6 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
LEAP: Sites also received the Learn. Engage. Act. Process. (LEAP) program, which is a 6-month quality improvement coaching program plus a 6-month follow-up.
|
|---|---|---|
|
Change in Number of Inappropriate Medications at a Patient-level
|
-0.00625 percentage of patients with PIMs
Interval -0.03369 to 0.02118
|
-0.05942 percentage of patients with PIMs
Interval -0.08509 to -0.03376
|
SECONDARY outcome
Timeframe: 13-18 months post-baselinePopulation: The number of participants refers to all individuals who were eligible for the cross sectional analysis at any time point in the DOAC study.
High-risk DOAC use will be assessed by "flags" using the algorithm from an operations DOAC dashboard. These flags were developed based on existing guidelines and advice of many anticoagulation experts. Percentage of patients with PIMs across AD vs. LEAP+AD facilities were modelled longitudinally using Generalized Estimating Equations, with a three way-interaction of arm, month of follow-up, and pre-, post-period. Data will was be collected monthly at patient level and collapsed by clinic-month for patients who are at risk of potentially inappropriate medication use. Estimates computed using LS means from the GEE model. This is the primary outcome for the DOAC trial when analyzed as a stand-alone trial and the DOAC sub-analysis of the overall MIDAS study primary outcome.
Outcome measures
| Measure |
Academic Detailing (AD) Only
n=4 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
|
AD + LEAP Combined
n=4 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
LEAP: Sites also received the Learn. Engage. Act. Process. (LEAP) program, which is a 6-month quality improvement coaching program plus a 6-month follow-up.
|
|---|---|---|
|
Change in Percentage of Patients With High-risk Direct Oral Anticoagulant (DOAC) Use Across Facilities
|
0.64 percentage of patients with a DOAC flag
Interval -0.38 to 1.66
|
0.53 percentage of patients with a DOAC flag
Interval -0.32 to 1.37
|
SECONDARY outcome
Timeframe: 13-18 months post-baselinePopulation: The number of participants refers to all individuals who were eligible for the cross sectional analysis at any time point in the DOAC study.
This was the subset of patients with DOAC Population Health Management Tool (Dashboard) flags that occur when medications are given at doses that would be appropriate but are not because the patient has abnormal renal function. This has had minimal adjustments since being described in previous publications.
Outcome measures
| Measure |
Academic Detailing (AD) Only
n=4 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
|
AD + LEAP Combined
n=4 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
LEAP: Sites also received the Learn. Engage. Act. Process. (LEAP) program, which is a 6-month quality improvement coaching program plus a 6-month follow-up.
|
|---|---|---|
|
Change in Percentage of Patients With Direct Oral Anticoagulant (DOAC) Flags Attributable to Chronic Kidney Disease Across Facilities
|
0.31 percentage of patients with a DOAC flag
Interval -0.12 to 0.75
|
0.11 percentage of patients with a DOAC flag
Interval -0.33 to 0.55
|
SECONDARY outcome
Timeframe: 13-18 months post-baselinePopulation: The number of participants refers to all individuals who were eligible for the cross sectional analysis at any time point in the DOAC study.
This was the subset of patients with DOAC Population Health Management Tool (Dashboard) flags that occur when medications are given at doses that would be appropriate but are not because the patient has unusually high or low weight or BMI. This has had minimal adjustments since being described in previous publications.
Outcome measures
| Measure |
Academic Detailing (AD) Only
n=4 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
|
AD + LEAP Combined
n=4 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
LEAP: Sites also received the Learn. Engage. Act. Process. (LEAP) program, which is a 6-month quality improvement coaching program plus a 6-month follow-up.
|
|---|---|---|
|
Change in Percentage of Patients With Direct Oral Anticoagulant (DOAC) Flags Attributable to Weight Across Facilities
|
0.17 percentage of patients with a DOAC flag
Interval -0.13 to 0.47
|
0.49 percentage of patients with a DOAC flag
Interval 0.22 to 0.76
|
SECONDARY outcome
Timeframe: 13-18 months post-baselinePopulation: The number of participants refers to all individuals who were eligible for the cross sectional analysis at any time point in the DOAC study.
These are the remaining high-risk flags and are usually due to patients with medication interactions or doses that are incorrect due to the indication. This has had minimal adjustments since being described in previous publications.
Outcome measures
| Measure |
Academic Detailing (AD) Only
n=4 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
|
AD + LEAP Combined
n=4 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
LEAP: Sites also received the Learn. Engage. Act. Process. (LEAP) program, which is a 6-month quality improvement coaching program plus a 6-month follow-up.
|
|---|---|---|
|
Change in Percentage of Patients With Direct Oral Anticoagulant (DOAC) Flags Attributable to Other Mis-dosing Across Facilities
|
0.20 percentage of patients with a DOAC flag
Interval -0.18 to 0.57
|
0.02 percentage of patients with a DOAC flag
Interval -0.34 to 0.37
|
SECONDARY outcome
Timeframe: 13-18 months post-baselinePopulation: The number of participants refers to all individuals who were eligible for the cross sectional analysis at any time point in the CBT-I study.
Patient receipt of any CBTI will be measured by extracting from the medical records CBTI note templates completed by CBTI therapists. The denominator will consist of primary care patients who are not in hospice/palliative care. Percentage of PIMs across AD vs. LEAP+AD facilities were modelled longitudinally using Generalized Estimating Equations, with a three way-interaction of arm, month of follow-up, and pre-, post-period. Data will was be collected monthly at patient level and collapsed by clinic-month for patients who are at risk of potentially inappropriate medication use. Estimates computed using LS means from the GEE model. This will be the primary outcome for the CBTI trial when analyzed as a stand-alone trial.
Outcome measures
| Measure |
Academic Detailing (AD) Only
n=4 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
|
AD + LEAP Combined
n=4 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
LEAP: Sites also received the Learn. Engage. Act. Process. (LEAP) program, which is a 6-month quality improvement coaching program plus a 6-month follow-up.
|
|---|---|---|
|
Change in Percentage of Patient Receipt of Any Cognitive Behavioral Therapy for Insomnia (CBTI) Across Facilities
|
-0.00922 percentage of patients receiving CBTI
Interval -0.042 to 0.02355
|
0.00085 percentage of patients receiving CBTI
Interval -0.00898 to 0.01067
|
SECONDARY outcome
Timeframe: 13-18 months post-baselinePopulation: After conducting additional testing of our algorithm for detecting CBTI sessions, we found the algorithm to be adequately sensitive to detecting \*any\* CBTI but not accurate for detecting the number of CBTI sessions (e.g., CBTI could often be mentioned in the context of a referral or some other ongoing treatment).
Mean number of sessions will be measured by extracting from the medical records CBTI note templates completed by CBTI therapists. The denominator will consist of primary care patients who are not in hospice/palliative care. This will be a secondary outcome for the CBTI trial when analyzed as a stand-alone trial.
Outcome measures
Outcome data not reported
SECONDARY outcome
Timeframe: 13-18 months post-baselinePopulation: It was originally planned for all CBTI sites to provide information regarding where in the medical records the investigators could identify referrals. However, prior to launching the trial, it was determined several of the sites' processes for referrals were not distinguishable as referrals vs. other forms of communication (e.g., adding a therapist as a cosigner to a note), making collection of this data impractical and not conducted. Thus, we did not have any sites collect referral information.
CBTI referrals will be measured according to counts of CBTI consult requests in the medical record. For clinics that do not use medical record consult requests specific to CBTI, referrals will be measured using monthly counts provided by CBTI therapists. The denominator will consist of primary care patients who are not in hospice/palliative care. This will be a secondary outcome for the CBTI trial when analyzed as a stand-alone trial.
Outcome measures
Outcome data not reported
SECONDARY outcome
Timeframe: 13-18 months post-baselinePopulation: The number of participants refers to all individuals who were eligible for the cross sectional analysis at any time point in the CBTI study.
The proportion of patients with a new prescription for a sleep medication for insomnia who have not had CBTI of those who are actively followed by the clinic and not in hospice/palliative care. This is a CBTI sub-analysis of the overall MIDAS study primary outcome.
Outcome measures
| Measure |
Academic Detailing (AD) Only
n=4 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
|
AD + LEAP Combined
n=4 VA medical centers and/or clinics
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
LEAP: Sites also received the Learn. Engage. Act. Process. (LEAP) program, which is a 6-month quality improvement coaching program plus a 6-month follow-up.
|
|---|---|---|
|
Change in Percentage of Patients With First Line Sleep Medication Across Facilities
|
0.02206 percentage of patients PIMs
Interval -0.06155 to 0.10567
|
-0.06164 percentage of patients PIMs
Interval -0.1565 to 0.03322
|
OTHER_PRE_SPECIFIED outcome
Timeframe: 18-months Post-baselinePopulation: The number of participants refers to those eligible for AD and/or LEAP participation at baseline and those who participated in AD and/or LEAP at post-implementation.
3-item pilot measure of the extent to which employees engage in quality improvement activities given both at baseline and 18-months post-implementation. Scores are 1-5 with higher ratings indicating more engagement in quality improvement.
Outcome measures
| Measure |
Academic Detailing (AD) Only
n=65 Participants
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
|
AD + LEAP Combined
n=69 Participants
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
LEAP: Sites also received the Learn. Engage. Act. Process. (LEAP) program, which is a 6-month quality improvement coaching program plus a 6-month follow-up.
|
|---|---|---|
|
Change in Employee Engagement in Quality Improvement
|
0.305 units on a scale
Interval -0.242 to 0.852
|
0.247 units on a scale
Interval -0.306 to 0.801
|
OTHER_PRE_SPECIFIED outcome
Timeframe: 18-months post-baselinePopulation: The number of participants refers to those eligible for AD and/or LEAP participation at baseline and/or those who participated in AD and/or LEAP at post-implementation.
3-item measure comprising one item each for exhaustion, depersonalization, and reduced achievement (reverse scored) given both at baseline and 18-months post-implementation. "High Burnout" measures the percent of staff who are feeling burned out on all three burnout items at a frequency of "once a week" to "every day." Scored: 0-100%, where LOWER score is more favorable.
Outcome measures
| Measure |
Academic Detailing (AD) Only
n=67 Participants
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
|
AD + LEAP Combined
n=70 Participants
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
LEAP: Sites also received the Learn. Engage. Act. Process. (LEAP) program, which is a 6-month quality improvement coaching program plus a 6-month follow-up.
|
|---|---|---|
|
Change in Employee Burnout
|
-0.586 units on a scale
Interval -1.298 to 0.127
|
0.227 units on a scale
Interval -0.441 to 0.895
|
OTHER_PRE_SPECIFIED outcome
Timeframe: 18-months post-baselinePopulation: The number of participants refers to those eligible for AD and/or LEAP participation at baseline and those who participated in AD and/or LEAP at post-implementation.
3-item scale. "Best Places to Work" (BPTW) is a summary measure of the group's satisfaction with the job, organization, and likelihood to recommend VA as a good place to work given both at baseline and 18-months post-implementation. The values are 1 to 5 with a higher score being more positive and the BPTW score is the average of the 3 questions. This is a measure normally administered within the All-employee Survey (AES) and the questions come from the Partnership for Public Service's BPTW survey (http://bestplacestowork.org).
Outcome measures
| Measure |
Academic Detailing (AD) Only
n=67 Participants
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
|
AD + LEAP Combined
n=71 Participants
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
LEAP: Sites also received the Learn. Engage. Act. Process. (LEAP) program, which is a 6-month quality improvement coaching program plus a 6-month follow-up.
|
|---|---|---|
|
Change in Best Places to Work Score
|
0.170 units on a scale
Interval -0.412 to 0.752
|
-0.056 units on a scale
Interval -0.636 to 0.524
|
OTHER_PRE_SPECIFIED outcome
Timeframe: 18-months post-baselinePopulation: The number of participants refers to those eligible for AD and/or LEAP participation at baseline and/or those who participated in AD and/or LEAP at post-implementation.
7-item measure from the VA's newly developed Patient Safety Culture given both at baseline and 18-months post-implementation. Values 1 to 5 where higher values indicate more positive scores.
Outcome measures
| Measure |
Academic Detailing (AD) Only
n=67 Participants
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
|
AD + LEAP Combined
n=68 Participants
Academic Detailing (AD): Site providers received one-on-one educational sessions between a non-physician professional trained in communication skills and the specific topic area (the Academic Detailer) aimed at increasing the use of the evidence-based practices.
LEAP: Sites also received the Learn. Engage. Act. Process. (LEAP) program, which is a 6-month quality improvement coaching program plus a 6-month follow-up.
|
|---|---|---|
|
Change in Workgroup Cohesion & Engagement
|
0.131 units on a scale
Interval -0.348 to 0.61
|
0.152 units on a scale
Interval -0.327 to 0.631
|
Adverse Events
Academic Detailing (AD) Only
AD + LEAP Combined
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Jeremy Sussman, MD, MS, Corresponding Principal Investigator
VA Ann Arbor Health Care System
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place