e-ALIGN: A Patient Portal-based Intervention to Align Medications With What Matters Most
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: e-ALIGN Patient-Portal Deprescribing.
- Who it may be relevant to
- Registry conditions: Dementia, Potentially Inappropriate Medication Use, Mild Cognitive Impairment (MCI). Basic parameters: from 65 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
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.
Interventions
- Other e-ALIGN Patient-Portal Deprescribing
The intervention will consist of educational materials about deprescribing, which will be sent to the patient prior to the scheduled primary care visit.
Primary outcome measures
- Number of patients who open the patient portal message [Time frame: 1 month after sending message]
- Number of patients who watch the video [Time frame: 1 month after sending message]
- Acceptability of educational video assessed by survey [Time frame: 1 month after sending message]
Secondary outcome measures (5)
- Number of patients or care partners that discussed deprescribing with any clinicians after receiving the message [Time frame: 3 months after sending message]
- Number of PCPs who send the referral [Time frame: 3 months after sending message]
- Number of patients who schedule the pharmacist visit [Time frame: 3 months after sending message]
- Number of patients who deprescribe ≥1 CNS-PIM after receiving the message [Time frame: 3 months after sending message (for patients who do NOT have a pharmacist visit)]
- Number of patients who start ≥1 CNS-PIM after receiving the message [Time frame: 3 months after sending message (for people who do NOT have a pharmacist visit)]
Eligibility criteria
Inclusion criteria
- 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.
Care partners:
- Family or other companions >21 years who regularly help the patient with managing medications.
Exclusion criteria
- As the trial will be based in primary care, individuals residing in long term care facilities or enrolled in hospice will be excluded.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- N/A
- Model
- Single group
- Masking
- Open label
- Primary purpose
- Health services research
Study locations
United States · 1 center
- Johns Hopkins Community Physicians — Baltimore
Identifiers
NCT: NCT07454824 · IRB00506634 · R01AG077011