Deprescribing for Older Dialysis Patients
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Kidney Failure, Chronic
- Sponsor
- Duke University
- Enrollment
- 48
- Locations
- 1
- Primary Endpoint
- Number of Deprescribing Events
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
Aim 1 of the study is to identify the elements of a deprescribing intervention that address contextual factors specific to dialysis.
Aim 2 of the study, described in this record, is to determine the feasibility of a deprescribing intervention tailored for older dialysis patients.
Older adults receiving dialysis are often prescribed multiple medications. Some of these medications are used to treat symptoms, but they also can increase the chance of significant health problems. The purpose of this study is to identify if it is feasible to reduce the use of medications that have been identified as causing an increased risk for health problems.
Investigators
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Number of Deprescribing Events
Time Frame: 3 months
Deprescribing events will be assessed for the Provider Only and Provider/Patient communication approaches. While this data is categorized into the two approaches, it is not intended for comparison.
Number of Potentially Eligible Subjects
Time Frame: Baseline
The study team identified patients aged 55 and older with active prescriptions for specific potentially inappropriate medications (PIMs) (gabapentinoids, clonidine, alpha blockers, muscle relaxants, and Z-drugs) from the medical record and met criteria for deprescribing.
Proportion of Clinicians Who Found the Deprescribing Program Met Their Approval
Time Frame: Baseline
This is an assessment of provider acceptability, defined as those who answered "agree" or "completely agree" to the Likert item: The deprescribing program meets my approval.
Proportion of Clinicians Who Found the Deprescribing Program Fit Their Routine
Time Frame: Baseline
This is an assessment of provider acceptability. The outcome was defined as those who answered "agree" or "completely agree" to the Likert item: The deprescribing program seems fitting with my clinical routine.
Proportion of Clinicians Who Found the Deprescribing Program Seemed Doable
Time Frame: Baseline
This is an assessment of provider acceptability. The outcome was defined as those who answered "agree" or "completely agree" to the Likert item: The deprescribing program seems doable.
Secondary Outcomes
- Number of Adverse Drug Withdrawal Events(3 months)
- Change in Functional Assessment(Baseline, 3 months)
- Change in Fall Risk Questionnaire(Baseline, 3 months)
- Change in Patient Health Questionnaire-9 (PHQ9)(Baseline, 3 months)
- Change in Cognitive Change Index(Baseline, 3 months)
- Sustainability, as Measured by the Proportion of Patients Who Remained Off PIM at a Lower Dose(3 months)
- Practicality, as Measured by Average Time (in Days) Spent Awaiting Provider Response to Deprescribing Recommendation(Baseline)
- Practicality, as Measured by the Average Time (in Days) to Initial Patient Communication(Baseline)
- Practicality, as Measured by the Average Number of Attempts to Reach the Patient(Baseline)
- Practicality, as Measured by the Average Number of Conversations(Baseline)
- Practicality, as Measured by the Average Length of Conversations With Patients About Deprescribing(Baseline)