CompletedNot Applicable

Deprescribing Potentially Inappropriate Medications in the Emergency Department for Persons Living With Dementia

United States300 participantsStarted 2024-07-09

Plain-language summary

Aim 1: To demonstrate the feasibility by determining proportion of completed medication reconciliation, Central Nervous System active Potentially Inappropriate Medication (CNS PIM) use among patients with Alzheimer's Disease and Related Dementias (ADRD) and Mild Cognitive Impairment (MCI) in the emergency department (ED), and communication between ED clinical pharmacists and outpatient prescribers. Aim 2: To demonstrate the feasibility of collecting the primary and secondary outcomes for a subsequent study. The future primary outcome will be reduction in CNS PIMs 90 days after an ED visit. Secondary outcomes will include outpatient follow-up, repeat ED visits, and hospitalizations during the 90 days following an ED visit. Aim 3: To demonstrate the acceptability of the PRIDE intervention to outpatient clinicians using the Acceptability of Intervention Measure and qualitative analysis of responses.

Who can participate

Age range18 Years – 120 Years

SexALL

See this in plain English?

AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.

Inclusion Criteria: * Community dwelling * 18 years of age or older * History of dementia or mild cognitive impairment in the problem list in the NM EHR. A history of mild cognitive impairment will be identified using the ICD-10 code G31.84 (mild cognitive impairment) or ICD-10 codes suggestive of ADRD as described in the Bynum-standard algorithm: F01.50-F01.51 (vascular dementia), F02.80-F02.81 (dementia), F03.90-F03.91 (unspecified dementia), F04 (amnestic disorder), G30.0/30.1/30.8/G30.9 (Alzheimer's disease), G31.01 (Pick's disease), G31.09 (frontotemporal dementia), G31.83 (dementia with Lewy bodies), G31.1 (senile degeneration), G31.2 (degeneration of nervous system), R41.81 (age-related cognitive decline). * Able to participate in medication reconciliation as determined by the pharmacist per usual care OR a care partner with knowledge of the patient's current medications is present in the ED or is available by phone. * Has had prior outpatient care performed at Northwestern Medicine location(s) * Arrives to the emergency department between 7am and 7pm, Monday-Friday Exclusion Criteria: * Emergency Severity Index (ESI) of 1 (critical) * ICU consult placed in the ED * Reside in nursing facility or assisted living facility

What they're measuring

Pharmacist communication of deprescribing recommendation

Timeframe: 24 hours

Trial details

NCT IDNCT06273917

SponsorNational Institute on Aging (NIA)

Sponsor typeNIH

Study typeINTERVENTIONAL

Primary completion2025-10-31