e-ALIGN: Using the patient portal to align medicines with what matters most
e-ALIGN: A Patient Portal-based Intervention to Align Medications With What Matters Most
This project will see if sending education through the patient portal plus pharmacist-led medication reviews helps people 65 and older with mild cognitive impairment or dementia and their care partners reduce risky brain-active medicines.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 100 (estimated) |
| Ages | 65 Years and up |
| Sex | All |
| Sponsor | Johns Hopkins University Academic / other |
| Locations | 1 site (Baltimore, Maryland) |
| Trial ID | NCT07454824 on ClinicalTrials.gov |
What this trial studies
The e-ALIGN pilot identifies older primary care patients (age ≥65) with mild cognitive impairment or dementia who have at least one active central nervous system potentially inappropriate medication and who use the patient portal. Participating patients and their care partners receive educational materials through the portal and a pharmacist conducts a medication review to align prescriptions with patient and care partner goals and target deprescribing of CNS-PIMs. The multicomponent, triadic intervention aims to increase engagement between patients, care partners, and clinicians and to build preliminary data and workflows for a future multisite embedded pragmatic trial. Outcomes will include changes in CNS-PIM use and measures of patient-centered alignment and well-being.
Who should consider this trial
Good fit: Ideal candidates are primary care patients aged 65 or older with mild cognitive impairment or dementia, at least one active CNS-PIM, active patient portal use, and a family or other care partner who helps manage medications.
Not a fit: People living in long-term care facilities or enrolled in hospice, those without patient portal access, or those without CNS-PIMs are unlikely to benefit from this intervention.
Why it matters
Potential benefit: If successful, the approach could reduce use of risky brain-active medications and improve care that better matches patients' goals and quality of life.
How similar studies have performed: Pharmacist-led deprescribing and medication-review interventions have shown benefit in reducing inappropriate medications, but delivering a triadic portal-based intervention for people with cognitive impairment is novel and largely untested.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Patients: Age ≥65, with a diagnosis of MCI or dementia based on ICD-10 codes and ≥1 active CNS-PIM, who are active patient portal users. Care partners: * Family or other companions \>21 years who regularly help the patient with managing medications. Exclusion Criteria: * As the trial will be based in primary care, individuals residing in long term care facilities or enrolled in hospice will be excluded.
Where this trial is running
Baltimore, Maryland
- Johns Hopkins Community Physicians — Baltimore, Maryland, United States (Recruiting)
Study contacts
- Principal investigator: Ariel Green, MD, MPH, PhD — Johns Hopkins University
- Study coordinator: Ariel Green, MD, MPH, PhD
- Email: ariel@jhmi.edu
- Phone: 410-550-6733
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.