Deprescribing in Patients Living With Dementia With Caregiver and Provider Nudges

Status: Recruiting
Location: See location...
Intervention Type: Behavioral
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

The objectives of this study are to demonstrate the feasibility of implementing a deprescribing nudge intervention using pragmatic methods, confirm that outcomes can be feasibly measured and evaluated at scale in a subsequent embedded pragmatic clinical trial (ePCT), and explore representativeness of persons living with dementia and care partners identified.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 65
Healthy Volunteers: f
View:

• Providers within Brigham and Women's Hospital primary care practices

• Having prescribed at least one of the high-risk medications of interest

⁃ Eligible patients will be identified through this providers within the health care system.

• At least 65 years of age

• Prescribed at least 90 pills of one of the high-risk medications of interest in the last 180 days in the EHR system, which most guidelines consider chronic use, and have a diagnosis of dementia in the EHR.

Locations
United States
Massachusetts
Mass General Brigham
RECRUITING
Boston
Contact Information
Primary
Julie Lauffenburger, PharmD, PhD
jlauffenburger@bwh.harvard.edu
617-525-8865
Time Frame
Start Date: 2024-08-01
Estimated Completion Date: 2025-12-31
Participants
Target number of participants: 360
Treatments
Experimental: Nudge internvention
PCPs will receive an enhanced EHR alert (nudge) that triggers when a PCP opens an encounter for an eligible patient living with dementia (PLWD). The nudge will provide information about the risks of continued medication use as well as tips and tools to help providers discuss medication discontinuation with patients and care partners. Additionally, the providers will receive a brief message in their in-basket 10 days before the patient's appointment as a reminder.~Eligible PLWD of a randomized PCP will receive the nudge intervention which includes a brief recommendation for the PLWD (and care partner, if available) via the linked patient portal prior to upcoming visits (unless explicitly opted out by the PCP) to discuss medications with the PCP at the visit and link to a general handout about medications, unless explicitly opted out by the PCP. For PLWD without a portal account, the handout will be sent to their mailing address recorded in the EHR.
Related Therapeutic Areas
Sponsors
Leads: Brigham and Women's Hospital
Collaborators: Brown University, National Institute on Aging (NIA)

This content was sourced from clinicaltrials.gov