Primary Care Drug Therapeutics CER in a Pediatric EHR Network
Project Number: R40 MC 24943 Grantee: Pediatric Research in Office Settings (PROS) Network of the American
Academy of Pediatrics (AAP) Department/Center: Project Date: 9/1/2012
Richard (Mort) Wasserman, MD, MPH 141 Northwest Point Blvd Elk Grove Village, IL 60007-1098 Phone: 847-434-7623 Email: firstname.lastname@example.org
Infancy (0-12 months)
Toddlerhood (1-2 years)
Early Childhood (3-5 years)
Middle Childhood (6-11 years)
Adolescence (12-18 years)
PROBLEM: The nation lacks a system to employ routinely-collected electronic health record
(EHR) data to conduct comparative effectiveness research (CER) on pediatric drug therapeutics.
GOAL(S) AND OBJECTIVES: Pediatric Research in Office Settings (PROS) will take up the
project goal of creating a fully elaborated system to employ clinical data in EHRs for conducting CER on pediatric drug therapeutics. PROS will link its own EHR-based ePROS network with experienced clinical informaticians at EHR-based networks at the Children's Hospital of Philadelphia, MetroHealth/Case Western Reserve, Boston University, and the American Academy of Family Physicians (AAFP). The "Comparative Effectiveness Research through Collaborative Electronic Reporting" (CER2) collaborators will undertake these objectives: (1) conduct four proof-of-concept CER studies on psychotropic and asthma medication use and side effects plus an additional full-scale CER study on treatment for pediatric hypertension (HTN); (2) advance the methodology of pediatric pharmacoepidemiological CER using EHR data; and (3) provide a platform for future CER studies in pediatric drug therapeutics and other topic areas. The CER2 collaborators will disseminate critical information on research findings on pediatric drug therapeutics to child health professionals, policy makers, and the public.
METHODOLOGY: The CER2 collaborating sites will include 112 sites from around the
country serving a racially and ethnically diverse group of over 800,000 children 0-18 years of
age. EHR data definitions will be standardized across sites. Data will be locally extracted and
deidentified and then transmitted securely to the data analysis team, where they will be stored on a secure server, aggregated, and analyzed. The proof-of-concept CER studies will provide new knowledge about the prevalence of atypical antipsychotic use and metabolic side effects, psychotropic polypharmacy, and prevalence and side effects of on and off-label use of asthma medications. The full-scale CER study of HTN will assess the prevalence of HTN, HTN diagnosis and medication management, and via a cluster randomized trial, test an EHR clinical decision support system to improve diagnosis and management of HTN, including the prescription of medication when indicated.
DISSEMINATION OF RESULTS: Results from this work will be disseminated via
publications and through collaborations with policymakers, educators, and leadership at both the AAP and AAFP in order to inform national guidelines, policies.