EVOLV-Rx VA: Evaluating Opportunities to Decrease Low-Value Prescribing in Community Living Centers

StatusEnrolling by Invitation
PhaseNot applicable
Started

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Trial flagged as At Risk
Primary endpoint reworded 1 of 1 changed
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Record History

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  1. Enrolling by invitation only Show 5 more changesShow less
    • Study sites: 2 to 3
    • Secondary endpoints revised (5)
    • Study description revised
    • Publications: details revised at 2 of 2 entries
    • Eligibility criteria expanded, about 3 words
  2. Start date: Sep 1, 2026 to Oct 1, 2026v4 Show 4 more changesShow less
    • Primary endpoint(s) modified
    • Secondary endpoints: details revised at 1 of 5 entries
    • Site contacts updated at 1 of 2 sites
    • Eligibility criteria expanded, about 1 word
  3. Study sites revised (2)v3
  4. Secondary endpoints revised (5)v2
  5. Study First Submitted
  • Notable: the trial’s plan changed such as a big move in its timeline or size, a new primary endpoint, sponsor or phase, or recruiting opened or resumed.
  • Minor: routine progress and housekeeping, such as sites added or enrollment closed.
The investigators developed EVOLV-Rx (Evaluating Opportunities to Decrease Low-Value Prescribing), a novel clinical support tool to detect 18 evidence-based and clinically useful low-value prescribing practices in older adults. The objective is to conduct a hybrid study to assess the effectiveness and implementation of an EVOLV-Rx-based intervention to reduce LVP among older Veterans who reside in CLCs in VISN 4. In Aim 1, the investigators will conduct focus groups of VISN 4 CLC leaders, clinicians, Veterans, and family caregivers, where the investigators will characterize the patient, clinician, and CLC-level barriers to and facilitators of implementation; and identify and tailor strategies to optimize the intervention's adoption and implementation. In Aim 2, the investigators will conduct a hybrid type 2 effectiveness implementation trial to compare the intervention to usual care, using a stepped wedge design in five VISN 4 CLCs. The primary effectiveness outcome is the count of low-value prescribing practices per 100 Veterans. In Aim 3, the investigators will conduct an embedded process evaluation to study implementation processes, their impact on outcomes, and iteratively improve the implementation of the intervention. The investigators will also conduct semi-structured interviews of clinicians, Veterans, and family caregivers to characterize the appropriateness, feasibility, acceptability, and perceived effectiveness of the intervention and implementation strategies employed.
Trial Details
NCT Number NCT07166107
Lead Sponsor VA Office of Research and Development
Conditions
(from sponsor)		 Low-Value Care
Enrollment 1,161 participants
Start Date
Primary Completion (estimated)
Study Completion (estimated)
Updated on ClinicalTrials.gov