Aligning Medications With What Matters Most (ALIGN)
Polypharmacy, Alzheimer Disease and Related Dementias
About this trial
This is an interventional health services research trial for Polypharmacy focused on measuring Deprescribing
Eligibility Criteria
Inclusion Criteria:
- Age 65 or greater
- Diagnosis of dementia from International Classification of Diseases (ICD) -9 or ICD-10 codes
- At least one other chronic condition
- Five or more chronic medications (to include all prescription and over-the-counter medications, both scheduled and as needed)
- Have a primary care physician at the pilot clinic who has enrolled in the study; this will be defined as having had at least 1 previous visit with that physician
Care partners:
- Family or other companions age 21 years or greater who regularly help the patient with managing medications
Exclusion Criteria:
- As both the pilot and the planned pragmatic trial will be based in primary care, individuals residing in long term care facilities or enrolled in hospice will be excluded.
- Individuals who cannot converse comfortably in English will be excluded because the FCMAHS has not been validated in other languages.
Sites / Locations
- Kaiser Permanente
- Johns Hopkins Bayview Medical Center
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Intervention
Delayed Intervention (wait list control)
The intervention consists of the following: mailing deprescribing educational materials to care partners and people living with dementia (PLWD); dyads will receive a telehealth visit with a clinical pharmacist to discuss the benefits and harms of the patient's medications with the patient and care partner in the context of their goals and preferences; pharmacist- primary care provider (PCP) communication in which the pharmacist provides tailored deprescribing recommendations to the PCP.
The delayed intervention consists of the following: mailing deprescribing educational materials to care partners and people living with dementia (PLWD); three months after mailing the deprescribing educational materials, dyads will receive a telehealth visit with a clinical pharmacist to discuss the benefits and harms of the patient's medications with the patient and care partner in the context of their goals and preferences. pharmacist- primary care provider (PCP) communication in which the pharmacist provides tailored deprescribing recommendations to the PCP.