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Development and validation of hospital information system-generated indicators of the appropriateness of oral anticoagulant prescriptions in hospitalised adults: the PACHA study protocol
  1. Aurélie Petit-Monéger1,2,
  2. Frantz Thiessard1,2,
  3. Vianney Jouhet1,2,
  4. Pernelle Noize2,3,
  5. Driss Berdaï3,
  6. Marion Kret1,
  7. Rémi Sitta1,
  8. Louis-Rachid Salmi1,2,
  9. Florence Saillour-Glénisson1,2
  10. The PACHA research group
  1. 1 CHU de Bordeaux, Pôle de santé publique, Service d’Information Médicale, Bordeaux, France
  2. 2 University of Bordeaux, ISPED, Centre INSERM U1219-Bordeaux Population Health, Bordeaux, France
  3. 3 CHU de Bordeaux, Pôle de santé publique, Service de Pharmacologie Médicale, Bordeaux, France
  1. Correspondence to Dr. Aurélie Petit-Monéger; aurelie.petit-moneger{at}u-bordeaux.fr

Abstract

Introduction The appropriateness of oral anticoagulant prescriptions is a major challenge to improve quality and safety of care. As indicators of the appropriateness of oral anticoagulant prescriptions are lacking, the aim of the study is to develop and validate a panel of such indicators, in hospitalised adults, from the hospital information system of two university hospitals in France.

Methods and analysis The study will be carried out in four steps: (1) a literature review to identify indicators of the appropriateness of oral anticoagulant prescriptions and their conditions of appropriateness; (2) a Delphi consensus method to assess the potential utility and operational implementation of the selected indicators; (3) techniques of medical data search to implement indicators from the hospital information system and; (4) a cross-sectional study to assess the ability of indicators to detect inappropriate oral anticoagulant prescriptions, performance of medical data search techniques for tracking or retrieving information and the ability of tools to be transferred into other institutions. The fourth step will include up to 80 patient hospital stays for each indicator, depending on the prevalence of inappropriate prescriptions estimated in interim analyses.

Ethics and dissemination This work addresses the current lack of quality indicators of the appropriateness of oral anticoagulant prescriptions. We aim to develop and validate such indicators for integrating them into hospital clinical practice, as part of a structured approach to improve quality and safety of care. As each hospital information system is different, we will propose tools transferable to other healthcare institutions to allow an automated construction of these indicators. The PACHA study protocol was approved by institutional review boards and ethics committees (CPP Sud-Ouest et Outre Mer III—DC 2016/119; CPP Ile-de-France II—CDW_2016_0014).

Registration details Clinical Trial.gov registration: NCT02898090.

  • Quality In Health Care
  • Public Health
  • Cardiology
  • Vascular Medicine

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors Conceiving the study: APM, FT, VJ, PN, DB, MK, LRS, FSG. Design of the study: APM, FT, VJ, PN, DB, MK, RS, LRS, FSG. Writing the protocol: APM, FT, VJ, PN, DB, MK, RS, LRS, FSG. All authors read and approved the final manuscript.

  • Funding This work was supported by the French Ministry of Health, Research Program on the French healthcare system performance 2015 (PACHA study, grant number: PREPS 15 0433) without having any role in the study design, collection, analysis and interpretation of data, writing of the report, nor in the decision to submit the article for publication.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Collaborators PACHA study steering committee: Dr Berdaï Driss (Bordeaux University Hospital, Bordeaux, France); Pr Burgun Anita (Georges Pompidou European Hospital, Paris, France); Pr Cuggia Marc (Rennes University Hospital, Rennes, France); Grabar Natalia (University of Lille, Lille, France); Dr Jouhet Vianney (Bordeaux University Hospital, Bordeaux, France); Mrs Kret Marion (Bordeaux University Hospital, Bordeaux, France); Dr Noize Pernelle (Bordeaux University Hospital, Bordeaux, France); Dr Petit-Monéger Aurélie (Bordeaux University Hospital, Bordeaux, France); Dr Saillour-Glénisson Florence (Bordeaux University Hospital, Bordeaux, France); Pr Salmi Louis-Rachid (Bordeaux University Hospital, Bordeaux, France); Mr Sitta Rémi (Bordeaux University Hospital, Bordeaux, France); Dr Thiessard Frantz (Bordeaux University Hospital, Bordeaux, France). PACHA study scientific committee: Dr Berdot Sarah (Georges Pompidou European Hospital, Paris, France); Pr Cholley Bernard (Georges Pompidou European Hospital, Paris, France); Pr Coste Pierre (Bordeaux University Hospital, Bordeaux, France); Dr Escudié Jean-Baptiste (Georges Pompidou European Hospital, Paris, France); Pr Fischer Anne-Marie (Georges Pompidou European Hospital, Paris, France); Dr Galloula Alexandre (Georges Pompidou European Hospital, Paris, France); Pr Gaussem Pascale (Georges Pompidou European Hospital, Paris, France); Mr Diallo Gayo (Bordeaux University, Bordeaux, France); Dr Gilleron Véronique (Bordeaux University Hospital, Bordeaux, France); Dr Grellet Jean (Bordeaux University Hospital, Bordeaux, France); Pr Juvin Philippe (Georges Pompidou European Hospital, Paris, France); Dr Lafargue Aurélie (Bordeaux University Hospital, France); Pr Loriot Marie-Anne (Georges Pompidou European Hospital, Paris, France); Dr Massot Julien (Georges Pompidou European Hospital, Paris, France); Dr Mauge Laetitia (Georges Pompidou European Hospital, Paris, France); Mrs Mougin Fleur (Bordeaux University, Bordeaux, France); Pr Nouette-Gaulain Karine (Bordeaux University Hospital, Bordeaux, France); Dr Puymirat Etienne (Georges Pompidou European Hospital, Paris, France); Mr Rance Bastien (Georges Pompidou European Hospital, Paris, France); Dr Rouanet François (Bordeaux University Hospital, Bordeaux, France); Dr Sabatier Brigitte (Georges Pompidou European Hospital, Paris, France); Pr Saint-Jean Olivier (Georges Pompidou European Hospital, Paris, France); Dr Siguret Virginie (Lariboisiere Hospital, Paris, France); Dr Valdenaire Guillaume (Bordeaux University Hospital, Bordeaux, France).

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