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Despite clinical guidelines recommending their avoidance, high-risk medications like benzodiazepines, sedative hypnotics, and antipsychotics are commonly prescribed to hospitalized older adults. Prior interventions have not fully addressed how physicians make prescribing decisions, particularly junior physicians experiencing stress or cognitive overload. This trial randomized first-year medical resident physicians to either brief simulation training aimed at improving prescribing decision-making or control. The intervention did not impact total high-risk prescribing to hospitalized older adults, but did influence how the interns prescribed, resulting in fewer as needed orders, suggesting possibly greater ownership of care. Results of the study will be published in 2024. NCT04668248

Co-Principal Investigators: Julie Lauffenburger PharmD, PhD and Niteesh Choudhry, MD, PhD

Pragmatic trial evaluating the impact of simulation training on high-risk prescribing to older adults by junior physicians

Lauffenburger JC, DiFrancesco MF, Bhatkhande G, Crum KL, Kim ES, Robertson T, Oran R, Hanken KE, Haff N, Coll MD, Avorn J, Choudhry NK

J Am Geriatr Soc

2024 March 8

Prescribing decision making by medical residents on night shifts: A qualitative study

Lauffenburger JC, Coll MD, Kim E, Robertson T, Oran R, Haff N, Hanken K, Avorn J, Choudhry NK

Med Educ

2022 October

Overcoming decisional gaps in high-risk prescribing by junior physicians using simulation-based training: Protocol for a randomized controlled trial

Lauffenburger JC, DiFrancesco MF, Barlev RA, Robertson T, Kim E, Coll MD, Haff N, Fontanet CP, Hanken K, Oran R, Avorn J, Choudhry NK

JMIR Res Protoc

2022 April

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