Secondary aims
Aim 2 will examine the effects of the initial alerts for new inappropriate DOAC prescriptions. In Aim 2a, we will examine the proportion of new inappropriate DOAC prescriptions that were changed within 7 days, without distinguishing between alert types. Then, in aim 2b, using a similar modeling approach to that used in the primary aim, we will assess whether patients whose prescribers were randomized to alerts that included DOAC pharmacist referrals were more likely to have their prescription changed than those that received the simple alert (alert 1 vs. 2).Aim 3 will assess the maintenance of our treatment effects by examining longitudinal change in the effect size for both notifications and alerts. For these analyses, we will extend our initial two-level multi-level model (patients nested in prescribers) used in aims 1 and 2 to a three-level multi-level model that also accounts for time since alerts/notifications were activated. These models will thus include all parameters in aim 1/2, a fixed effect for time in months (0 to 18) since the alerts or notifications were turned on, and an interaction between time and treatment.