e-ALIGN: A Patient Portal-based Intervention to Align Medications With What Matters Most
Purpose
The overarching goal of this study is to pilot an intervention in which older adults with mild cognitive impairment and dementia and the older adult's care partners are identified in primary care and provided with educational materials through the patient portal to engage the participant in deprescribing. The multicomponent intervention, e-Align, includes delivery of educational information through the patient portal, and a pharmacist-led intervention to align medications with patient and care partner goals and reduce use of central nervous system (CNS) potentially inappropriate medicines (PIM). This work will establish the preliminary data, methods, and partnerships to undertake a multisite embedded pragmatic clinical trial. The resulting triadic-based behavioral intervention will promote patient and care partner engagement, and foster care that aligns with patients' values, and promote improved health and well-being outcomes for people with cognitive impairment and the patient's care partners through deprescribing.
Conditions
- Dementia
- Potentially Inappropriate Medication Use
- Mild Cognitive Impairment (MCI)
Eligibility
- Eligible Ages
- Over 65 Years
- Eligible Sex
- All
- Accepts Healthy Volunteers
- Yes
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.
Study Design
- Phase
- N/A
- Study Type
- Interventional
- Allocation
- N/A
- Intervention Model
- Single Group Assignment
- Primary Purpose
- Health Services Research
- Masking
- None (Open Label)
- Masking Description
- Due to the nature of the intervention, participants cannot be masked.
Arm Groups
| Arm | Description | Assigned Intervention |
|---|---|---|
|
Experimental Patient Portal Deprescribing Intervention |
e-ALIGN will be piloted via the patient portal. The intervention will provide patients and care partners with an educational video on the risks of Central Nervous System-Potentially Inappropriate Medications (CNS-PIM) through the patient portal, MyChart. It will also offer the participant the opportunity to discuss deprescribing options with the patient's primary care physician (PCP) or to receive a referral to discuss deprescribing options with a clinical pharmacist who is embedded in the primary care practice. Patients who meet with the pharmacist will have two visits (intervention and follow-up). Patients who do not meet with a pharmacist will have a routine visit with the patient's PCP. Each participant will be on study (intervention period and additional follow-up) for approximately 3 months. |
|
Recruiting Locations
Baltimore, Maryland 21209
Ariel Green, MD, MPH, PhD
More Details
- NCT ID
- NCT07454824
- Status
- Recruiting
- Sponsor
- Johns Hopkins University