Reducing inappropriate medications for dementia patients in the emergency department
Deprescribing Potentially Inappropriate Medications in the Emergency Department for Persons Living with Dementia
NA · National Institute on Aging (NIA) · NCT06273917
This study is testing a new approach where pharmacists help reduce unnecessary medications for people with dementia who visit the emergency department to see if it improves their care and health outcomes.
Quick facts
| Phase | NA |
|---|---|
| Study type | Interventional |
| Enrollment | 290 (estimated) |
| Ages | 18 Years to 120 Years |
| Sex | All |
| Sponsor | National Institute on Aging (NIA) (nih) |
| Locations | 3 sites (Chicago, Illinois and 2 other locations) |
| Trial ID | NCT06273917 on ClinicalTrials.gov |
What this trial studies
This clinical trial aims to evaluate the feasibility of a pharmacist-led intervention called PRIDE, which focuses on deprescribing potentially inappropriate medications for patients with Alzheimer's Disease and Related Dementias (ADRD) or Mild Cognitive Impairment (MCI) in the emergency department (ED). The study will assess the proportion of medication reconciliations completed, the communication of deprescribing recommendations, and the acceptability of the intervention among outpatient clinicians. It will also track patient outcomes, including follow-up care and hospital readmissions, over a 90-day period following an ED visit. The intervention is designed to be integrated into standard care within the Northwestern Medicine healthcare system.
Who should consider this trial
Good fit: Ideal candidates for this study are community-dwelling adults aged 18 and older with a documented history of dementia or mild cognitive impairment who have received prior outpatient care within the Northwestern Medicine system.
Not a fit: Patients who do not have a history of dementia or mild cognitive impairment, or those who have not received outpatient care within the Northwestern Medicine system, may not benefit from this study.
Why it matters
Potential benefit: If successful, this intervention could lead to safer medication practices and improved health outcomes for patients living with dementia.
How similar studies have performed: Other studies have shown promise in deprescribing interventions for older adults, suggesting that this approach may be effective, although the specific PRIDE intervention is novel.
Eligibility criteria
Show full inclusion / exclusion criteria
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
Where this trial is running
Chicago, Illinois and 2 other locations
- Northwestern Memorial Hospital — Chicago, Illinois, United States (RECRUITING)
- Northwestern Medicine Lake Forest Hospital — Lake Forest, Illinois, United States (RECRUITING)
- Northwestern Medicine Palos Hospital — Palos Heights, Illinois, United States (RECRUITING)
Study contacts
- Principal investigator: Scott Dresden, Dr. — Northwestern University- Department of Emergency Medicine
- Study coordinator: Scott Dresden, Dr.
- Email: s-dresden@northwestern.edu
- Phone: 312-926-6494
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.
Conditions: Dementia, Depresribing Medication