Pharmacist-led Deprescribing for Alzheimer's Disease
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial aims to determine if a pharmacist-led program can help people with dementia safely reduce their medication count. Participants will receive a brochure and have a telehealth chat with a pharmacist to discuss the pros and cons of their medications, tailored to their personal goals. The trial will compare those who receive the intervention immediately to those on a waitlist to see if more people stop at least one medication within three months. People with dementia who take five or more medications and have had a primary care visit in the past year might be suitable candidates. As an unphased trial, this study offers patients a unique opportunity to contribute to innovative care strategies for dementia.
Will I have to stop taking my current medications?
The trial involves a process called deprescribing, which means you might stop taking some medications. A pharmacist will discuss your medications with you and your care partner to decide what's best for you.
What prior data suggests that this pharmacist-led deprescribing intervention is safe?
Research has shown that when pharmacists help reduce or stop certain medications for people with dementia, it is generally safe. In previous studies, patients tolerated these changes well. Pharmacists reviewed patients' medications to eliminate drugs that might be unnecessary or harmful, and this process did not cause any serious side effects.
One study examined the impact of pharmacist-led medication reviews on patients with dementia. It found that these patients experienced fewer drug-related issues without significant negative effects. The success of these reviews often depended on effective communication between pharmacists and doctors.
This approach does not involve adding new medications. Instead, it focuses on reducing or stopping some medications that might not be beneficial, resulting in a low risk of new side effects from the process itself.12345Why are researchers excited about this trial?
Researchers are excited about this trial because it explores a pharmacist-led deprescribing approach for Alzheimer's patients. Unlike the standard of care, which often involves managing symptoms with medications, this method focuses on reducing medication load by carefully evaluating the benefits and risks of each drug. This personalized approach can help align treatment with the patient's goals and preferences, potentially improving their quality of life. By involving pharmacists directly in the treatment process and leveraging telehealth, this trial could pave the way for more accessible and tailored care for those living with Alzheimer's.
What evidence suggests that this pharmacist-led deprescribing intervention is effective for Alzheimer's disease?
This trial will compare a pharmacist-led deprescribing intervention with a delayed intervention (wait list control) for people living with dementia (PLWD). Research has shown that when pharmacists assist people with dementia in reviewing their medications, management improves. In a small study, patients who collaborated with pharmacists were more likely to stop taking at least one unnecessary medication. This approach ensures that medications align with the patient's needs, reducing side effects and enhancing safety. Another review found that reducing unnecessary medications can improve health in older adults with dementia. These findings suggest that pharmacist involvement can greatly enhance medication management for people with dementia.12678
Who Is on the Research Team?
Ariel Green, MD, MPH, PhD
Principal Investigator
Johns Hopkins University
Are You a Good Fit for This Trial?
This trial is for people aged 65 or older with dementia, taking five or more medications, and have visited their primary care clinic in the past year. A family member or companion over 21 who helps manage their meds must also participate. It's not for those in long-term care or hospice, nor for those unable to communicate by phone in English.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Intervention
Participants receive a deprescribing educational brochure, a telehealth visit with a pharmacist, and pharmacist-PCP communication for deprescribing recommendations
Follow-up
Participants are monitored for changes in medication use and shared decision-making outcomes
What Are the Treatments Tested in This Trial?
Interventions
- Pharmacist-led deprescribing intervention
Pharmacist-led deprescribing intervention is already approved in United States for the following indications:
- Dementia care
- Polypharmacy management
Find a Clinic Near You
Who Is Running the Clinical Trial?
Johns Hopkins University
Lead Sponsor
National Institute on Aging (NIA)
Collaborator