Deprescribing of Diabetes Regimens in Long Term Care Residents With Alzheimer's

Study Overview
=================
Brief Summary
-----------------
Objectives To 1) examine the ability of the STRIDE (Simplification of Treatment Regimens and Individualized Diabetes Education) educational program to increase deprescribing of high hypoglycemia risk glucose-lowering medications (HRMs) among long term care facility (LTCF) residents with ADRD, 2) assess key implementation constructs (secondary outcomes) of the STRIDE program, including acceptability, appropriateness, and feasibility, and 3) validate the primary HRM use outcome measure.

Official Title
-----------------
Deprescribing of Diabetes Treatment Regimens in Long Term Care (LTC) Residents With Alzheimer's Disease or Related Dementias (ADRD)

Conditions
-----------------
Diabetes, Dementia, Hypoglycemia; Drug

Intervention / Treatment
-----------------
* Behavioral: STRIDE


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Clinical staff at the LTCF (MDs, PAs, NPs, clinical pharmacists) - (Targeted providers for STRIDE program) Clinical staff that participated in the STRIDE program (Providers doing stakeholder exit interviews) Exclusion Criteria: Consistent with the pragmatic nature of the trial, there are no exclusion criteria.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: STRIDE Intervention<br>Educational intervention for clinicians | Behavioral: STRIDE<br>* a. Targeted providers for STRIDE program: i. Clinical staff at the LTCF who participate in deprescribing at the facilities (physicians (MDs), physician's assistants (PAs), nurse practitioners (NPs), clinical pharmacists): clinical staff members caring for LTCF residents with ADRD and diabetes at 6 LTCFs in the Ohio and Michigan areas will be invited via email from the LTCF leadership to participate in the STRIDE education program. The STRIDE program consist of practical algorithms and educational material, which they are free to view at any time, and participation in 2 webinars and monthly telementoring calls<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in proportion of long term care facility (LTCF) residents with Alzheimer's disease adn related dementias (ADRD) and diabetes with high risk medications (HRM) use | HRM use will include any sulfonylurea use (i.e., glyburide, glipizide, glimepiride, or chlorpropamide) and any insulin use. | Baseline vs 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acceptability of the STRIDE Educational Program | The extent to which the program is agreeable to LTCF staff- using the Acceptability of Intervention Measure (AIM) | 6 months | 
| Appropriateness of the STRIDE Educational Program | The extent to which the program is suitable for a particular purpose, i.e., to improve the frequency at which LTCF staff attempt diabetes medication regimen deprescribing- using the Intervention Appropriateness Measure (IAM) | 6 months | 
| Feasibility of the STRIDE Educational Program | The extent to which the program is practical at the LTCF level- using the Feasibility of Intervention Measure (FIM) | 6 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
older adults, long term care facility, high risk medications, hypoglycemia, deprescribing, diabetes, dementia