e-ALIGN for Cognitive Impairment
(e-ALIGN Trial)
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial tests a new approach called e-ALIGN to help individuals with mild cognitive impairment or dementia manage their medications more effectively. The goal is to reduce the use of medications that may not be safe for the brain by providing educational materials and pharmacist support through a patient portal. This approach can align medication with the goals of the patient and their caregiver, potentially improving health and well-being. Individuals aged 65 or older, diagnosed with mild cognitive impairment or dementia, and using medications that affect the brain might be suitable for this trial. As an unphased trial, this study offers a unique opportunity to contribute to innovative research that could enhance medication management for cognitive health.
Do I need to stop my current medications for the trial?
The trial involves reducing the use of certain medications that may not be suitable for your condition. A pharmacist will help align your medications with your health goals, which might mean stopping or changing some of your current medications.
What prior data suggests that the e-ALIGN intervention is safe for older adults with cognitive impairment?
Research has shown that deprescribing, which involves reducing or stopping certain medications, is generally safe for people with mild memory problems or dementia. While the benefits of deprescribing can vary, studies have found it is usually well-tolerated. Some medications might cause symptoms to return when stopped, but researchers monitor these situations closely. Overall, this process helps ensure that medications align with the patient's needs and goals, potentially improving their well-being.12345
Why are researchers excited about this trial?
Researchers are excited about the e-ALIGN Patient-Portal Deprescribing method for cognitive impairment because it introduces an innovative approach to managing medication risks. Unlike traditional treatments that often involve adjusting or adding medications, e-ALIGN focuses on deprescribing potentially inappropriate medications through an interactive and educational platform. This method empowers patients by providing them with educational resources about the risks of certain medications and facilitates direct communication with healthcare providers through a digital portal. By integrating technology with personalized care, this trial aims to safely reduce medication burden and improve cognitive health outcomes.
What evidence suggests that the e-ALIGN Patient-Portal Deprescribing intervention is effective for cognitive impairment?
Research has shown that deprescribing—carefully stopping or reducing medications—can benefit people with dementia or mild cognitive impairment. This trial will pilot the e-ALIGN Patient-Portal Deprescribing intervention to deliver educational materials through a patient portal. Studies have found that sharing educational materials via a patient portal can help patients and their caregivers understand and discuss potentially harmful medications. This approach can lead to more careful medication use, potentially improving health outcomes. Previous studies have demonstrated the feasibility of these interventions, although they may require significant resources. Using portals in this way is promising because they facilitate communication and education, enhancing patient and caregiver involvement.12467
Who Is on the Research Team?
Ariel Green, MD, MPH, PhD
Principal Investigator
Johns Hopkins University
Are You a Good Fit for This Trial?
This trial is for adults aged 65 or older with mild cognitive impairment or dementia who are using at least one potentially inappropriate brain-affecting medication and use a patient portal. Their care partners (family or companions over age 21 who help manage medications) can also participate. People in nursing homes or hospice can't join.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Intervention
Participants receive educational materials through the patient portal and have the opportunity to discuss deprescribing with a PCP or clinical pharmacist
Follow-up
Participants are monitored for engagement and outcomes related to deprescribing
What Are the Treatments Tested in This Trial?
Interventions
- e-ALIGN Patient-Portal Deprescribing
Trial Overview
The study tests an online program called e-ALIGN, which gives educational materials through the patient portal and involves a pharmacist to help reduce unnecessary brain-related medicines, making sure treatments match what matters most to patients and their caregivers.
How Is the Trial Designed?
1
Treatment groups
Experimental Treatment
e-ALIGN will be piloted via the patient portal. The intervention will provide patients and care partners with an educational video on the risks of Central Nervous System-Potentially Inappropriate Medications (CNS-PIM) through the patient portal, MyChart. It will also offer the participant the opportunity to discuss deprescribing options with the patient's primary care physician (PCP) or to receive a referral to discuss deprescribing options with a clinical pharmacist who is embedded in the primary care practice. Patients who meet with the pharmacist will have two visits (intervention and follow-up). Patients who do not meet with a pharmacist will have a routine visit with the patient's PCP. Each participant will be on study (intervention period and additional follow-up) for approximately 3 months.
Find a Clinic Near You
Who Is Running the Clinical Trial?
Johns Hopkins University
Lead Sponsor
National Institute on Aging (NIA)
Collaborator
Citations
Characterizing patient portal use of people with cognitive ...
To target portal interventions, we sought to identify individuals with cognitive impairment and CNS-PIM exposure who discussed medications ...
A Patient Portal-based Intervention to Align Medications ...
The overarching goal of this study is to pilot an intervention in which older adults with mild cognitive impairment and dementia and the older ...
Study Details | NCT04938648 | Aligning Medications With ...
The Aligning Medications with What Matters Most (ALIGN) study will assess the feasibility and preliminary efficacy of a deprescribing intervention to reduce ...
Deprescribing for people living with dementia: ALIGNing ...
The study demonstrates that primary care deprescribing interventions are feasible for many PLWD but these interventions are resource intensive.
5.
researchgate.net
researchgate.net/publication/384540870_Use_of_the_Patient_Portal_to_Discuss_Medications_Among_People_with_Dementia_and_Their_Care_PartnersUse of the Patient Portal to Discuss Medications Among ...
Objective To target portal interventions, we sought to identify individuals with cognitive impairment and CNS‐PIM exposure who discussed ...
6.
iadrp.nia.nih.gov
iadrp.nia.nih.gov/project/ealign-patient-portal-based-intervention-align-medications-what-matters-most-0EALIGN: A PATIENT PORTAL-BASED INTERVENTION TO ...
The website is undergoing maintenance and updates. As a result, at this time, the publicly available data are not complete. Please contact the IADRP team (iadrp ...
The effect of deprescribing interventions on mortality and ...
The primary outcome was mortality. Secondary outcomes were adverse drug withdrawal events, physical health, cognitive function, quality of life ...
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