e-ALIGN: A Patient Portal-based Intervention to Align Medications With What Matters Most
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age65+
SponsorJohns Hopkins University
About this trial
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.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
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.
Family or other companions >21 years who regularly help the patient with managing medications.
Disqualifiers
As the trial will be based in primary care, individuals residing in long term care facilities or enrolled in hospice will be excluded.
Trial design
Design model
Single group
Treatments tested in this trial
e-ALIGN Patient-Portal Deprescribing
Other interventionThe intervention will consist of educational materials about deprescribing, which will be sent to the patient prior to the scheduled primary care visit.
Treatment groups
100 Participants
are divided into 1 treatment groupGroup A: Patient Portal Deprescribing InterventionExperimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
Number of patients who open the patient portal message
The investigators will assess the number of patients and/or care partners who read the patient portal message sent by the study team, which invites the participant to meet with a clinical pharmacist for deprescribing.
Time frame
1 month after sending message2
Number of patients who watch the video
The investigators will assess the number of patients who click and watch the educational video about CNS-PIM and deprescribing.
Time frame
1 month after sending message3
Acceptability of educational video assessed by survey
The investigators will assess the acceptability of the educational video by administering a survey to participants. The survey will ask participants to rate various features of the video on a 5-point Likert scale, where a higher score indicates greater acceptability.
Time frame
1 month after sending messageSecondary outcomes
1
Number of patients or care partners that discussed deprescribing with any clinicians after receiving the message
Study team will follow up to assess if deprescribing was discussed with a clinician after receiving the patient portal message by conducting a review of patients' chart.
Time frame
3 months after sending message2
Number of PCPs who send the referral
Study team will assess how many PCPs send a referral to clinical pharmacy for patients who have been identified as candidates for deprescribing.
Time frame
3 months after sending message3
Number of patients who schedule the pharmacist visit
The investigators will determine the number of patients and/or care partners who schedule a visit with a clinical pharmacist for deprescribing CNS-PIM following receipt of the patient portal message.
Time frame
3 months after sending message4
Number of patients who deprescribe ≥1 CNS-PIM after receiving the message
For those who do not schedule a pharmacist visit, the investigators will evaluate the number of patients who deprescribed at least 1 CNS-PIM after receiving the patient portal message.
Time frame
3 months after sending message (for patients who do NOT have a pharmacist visit)Sponsors and contacts
Click on the lead sponsor to view all of their trials.
Johns Hopkins University
Lead sponsor
National Institute on Aging (NIA)
Collaborator
Source ClinicalTrials.gov