Deprescribing to Reduce Injurious Falls Among Older Adults With Dementia

Study Overview
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Brief Summary
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STOP-FALLS-D is an educational intervention to inform and activate patients, their care partner(s), and their primary care providers to work together to reduce use of central nervous system (CNS) active medications and prevent adverse outcomes (falls and injuries) associated with their use.

Detailed Description
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The study design is a pragmatic, one-arm pilot trial to test the feasibility and acceptability of implementing a deprescribing intervention with older people with dementia and their care partners in primary care. The level of randomization is the clinic. A sample of 120 eligible participants and their primary care providers will receive the intervention, which consists of patient-facing educational brochures on CNS-active medications and decision support for the primary care provider. Ethnic/minority groups will be over-sampled to ensure a diverse study sample.

Official Title
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Deprescribing to Reduce Injurious Falls Among Older Adults With Dementia

Conditions
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Dementia

Intervention / Treatment
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* Behavioral: STOP Falls D Educational Intervention


Participation Criteria
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Eligibility Criteria
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Older Adult Sample Inclusion Criteria: Diagnosed dementia (dementia diagnosis code or prescription for dementia medication) Receiving primary care at a Kaiser Permanente Washington integrated group practice outpatient clinic Prescribed at least one CNS-active medication on a chronic (3 months or more) basis Exclusion Criteria: Skilled nursing facility resident Current cancer diagnosis On hospice or palliative care Care Partner Sample Inclusion Criteria: Aged 18 years or older Self-identify as a care partner for the older adult with dementia

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Educational Intervention<br>Educational Intervention | Behavioral: STOP Falls D Educational Intervention<br>* This is one-arm, health-system embedded pragmatic pilot trial<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Medically treated falls | Percent of study sample with a fall-related healthcare visit | Through study completion, up to 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| All-cause emergency department visit or hospitalization | Percent of study sample with an emergency department visit or hospitalization for any reason | Through study completion, up to 6 months | 
| Skilled nursing facility placement | Percent of study sample admitted to a skilled nursing facility | Through study completion, up to 6 months |