Priorities Aligned Deprescribing for Persons Living With Dementia and Their Caregiver

Purpose

The purpose of this study is to compare patient priorities care (PPC) and usual care (UC) patients to identify differences in post-encounter medication changes, treatment burden (TBQ), and shared decision making in Older Patient Assessment of Chronic Illness Care (OPACIC), to understand PPC participant's sense-making and communication approaches related to deprescribing decisions in relation to the identified health priorities and to identify and categorize adverse drug withdrawal events (ADWEs)

Condition

  • Dementia

Eligibility

Eligible Ages
Over 55 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Dementia listed as an active problem in the medical record, including Alzheimer's disease, vascular dementia, frontotemporal dementia, Parkinson's dementia, Lewy body disease. - The functional assessment staging tool (FAST) score of 5 or lower (This will be established by the patient's clinician). - 2 or more additional chronic conditions - Takes 5 or more regular medications and - A caregiver present during visits. Caregivers may include family members or unrelated caregivers and will be identified through chart review and confirmed by clinician, patient, and surrogate decision maker if necessary. Identified caregivers must be involved in decisions and care of People living with dementia (PLWD) and routinely attend clinic visits with patient

Exclusion Criteria

  • FAST score of 6 or more (This will be established by the patient's clinician). - Significant hearing, vision, or advanced cognitive impairment that limits ability to participate in PPC encounters, - Caregiver is unwilling or able to participate in visits, or - Deemed ineligible by their Primary care physician (PCP)

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Non-Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Supportive Care
Masking
Single (Investigator)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
PPC
  • Behavioral: PPC
    Participants will have an encounter with a facilitator who will identify priorities (outcome goals and care preferences) from the dyads and transmits them in the electronic health records (EHR), and a follow-up encounter with their usual geriatric care provider to decide upon changes in their care that align with the identified priorities.
Active Comparator
Usual Care
  • Behavioral: Usual care
    Participants will have a geriatric clinic visit with a geriatrician that acts as their primary care provider (PCP) , in which the dyads will be encouraged by an unblinded study coordinator to ask about reducing medication burden.

Recruiting Locations

The University of Texas Health Science Center at Houston
Houston, Texas 77030
Contact:
Aanand Naik, MD
713-500-9156
Aanand.Naik@uth.tmc.edu

More Details

Status
Recruiting
Sponsor
The University of Texas Health Science Center, Houston

Study Contact

Aanand D Naik, MD
713-500-9156
Aanand.Naik@uth.tmc.edu