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Priorities Aligned Deprescribing for Persons Living With Dementia and Their Caregiver

Not Applicable
Recruiting
Conditions
Dementia
Interventions
Behavioral: Usual care
Behavioral: PPC
Registration Number
NCT05970315
Lead Sponsor
The University of Texas Health Science Center, Houston
Brief Summary

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)

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
50
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

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Usual CareUsual care-
PPCPPC-
Primary Outcome Measures
NameTimeMethod
Number, likelihood, and severity of adverse drug reactions (ADRs) as assessed by the Naranjo scale3 months

Naranjo scale is a 10 item questionnaire.Total scores range from -4 to +13; the reaction is considered definite if the score is 9 or higher, probable if 5 to 8, possible if 1 to 4, and doubtful if 0 or less.

Change in patient reported treatment burden as assessed by the Treatment Burden Questionnaire (TBQ)Baseline, 3 month

This is a 15 item questionnaire and each is scored from 0(not a problem) to 10(big problem) for a maximum score of 150, higher number indicating more burden

Number of medication changesBaseline, 3 month
Type of medication changesBaseline, 3 month
Number, likelihood, and severity of adverse drug withdrawal events (ADWEs) as assessed by the Naranjo scale3 months

Naranjo scale is a 10 item questionnaire.Total scores range from -4 to +13; the reaction is considered definite if the score is 9 or higher, probable if 5 to 8, possible if 1 to 4, and doubtful if 0 or less.

Secondary Outcome Measures
NameTimeMethod
Patient perceived chronic disease care as assessed by the Older Patient Assessment of Chronic Illness Care (OPACIC) scoreBaseline, 3 months

This is a 10 item questionnaire and each is scored from 1(almost never) to 5(almost always),for a maximum score of 50 ,higher scores indicate better perceived chronic disease care

Trial Locations

Locations (1)

The University of Texas Health Science Center at Houston

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Houston, Texas, United States

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