Deprescribing Potentially Inappropriate Medications in the Emergency Department for Persons Living with Dementia

Launched by NATIONAL INSTITUTE ON AGING (NIA) · Feb 20, 2024

Keywords

ClinConnect Summary

This clinical trial is studying how to safely reduce the use of certain medications that may not be suitable for people with dementia when they visit the emergency department (ED). The goal is to ensure that medications are reviewed carefully and that communication happens between the pharmacists in the ED and the doctors who will care for these patients afterward. Researchers want to see if they can collect important information about how well this approach works over time, particularly in reducing unnecessary medications and preventing future hospital visits.

To be eligible for this trial, participants need to be at least 18 years old and have a diagnosis of dementia or mild cognitive impairment. They should also be living in the community, be able to discuss their medications with a pharmacist, and have received care at a Northwestern Medicine location before. If you or a loved one decides to participate, you can expect to work with a pharmacist in the ED who will help review medications and communicate with your regular doctors. This trial is currently recruiting participants, and it’s important to note that individuals with critical emergency conditions or those living in care facilities are not eligible.

Gender

ALL

Eligibility 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