Developing a program to educate and sensitize caregivers to reduce the inappropriate prescription burden in elderly with alzheimer's disease study (d-prescribe-ad)

Ended Project Grant Awarded Last action

Award ID
R33AG069794
Recipient
Awarding agency
Obligated
$7,241,890

Award facts

Assistance listing
93.866 Aging Research
Completion date
Originally
Funding
  • $6,189,566.96 Federal
  • $1,052,323.00 Non-federal
Place of performance
Worcester, MA 01655, USA

Award details come from USAspending.gov.

Description

Abstract
Potentially inappropriate prescribing includes the use of medications that may no longer be necessary or that may increase the risk of harm. Inappropriate prescribing is a "morbidity multiplier," increasing overall symptom burden, and adversely affecting health-related quality of life and function. Inappropriate prescribing of certain drug categories such as sedative/hypnotics, antipsychotics, highly anticholinergic agents, and certain oral hypoglycemic medications poses particular risks for older adults, and may be more prevalent among those with alzheimer's disease and alzheimer's disease-related dementias (ad/adrd) due to a higher prevalence of multimorbidity and associated polypharmacy. The developing a program to educate and sensitize caregivers to reduce the inappropriate prescription burden in elderly with alzheimer's disease study (d-prescribe- ad) will test a health plan-based intervention leveraging the NIH collaboratory's distributed research network, which uses the food and drug administration (FDA) sentinel initiative infrastructure. The overarching goal of our proposal is to develop, implement, and evaluate the effect of a patient/caregiver-centered, multifaceted educational intervention on inappropriate prescribing in patients with ad/adrd. Our research hypothesis is that education on inappropriate prescribing among patients/caregivers and their providers can reduce medication-related morbidity in patients with ad/adrd and lead to an improvement in medication safety for this vulnerable population. Our study population will include community-dwelling patients with ad/adrd, identified based on a diagnosis of ad/adrd or use of a medication for alzheimer's disease, who have evidence of inappropriate prescribing. We will evaluate the effect of educational interventions designed to stimulate patient/caregiver-provider communication about medication safety (versus usual care) on the proportion of patients with inappropriate prescribing, the primary outcome of this study. The trial will be health plan-based, conducted in two large, national health plans. The study design will be a prospective, cluster randomized, comparative effectiveness intervention trial with three arms: (1) a combined patient/caregiver and provider educational intervention; (2) a provider only educational intervention; and (3) usual care. A one-year R61 planning phase will precede a four-year R33 implementation phase. During the R33 phase we will sequentially implement two separate pragmatic trials, each enrolling over 11,000 patients, adapting the second trial based on the findings and experience gained in the first. The R33 aims are: (1) to assess the impact of the patient/caregiver educational intervention on inappropriate prescribing to ad/adrd patients, employing a prospective, cluster randomized trial design with three arms; and (2) to create a plan for disseminating study findings to stakeholders who might implement the intervention or make decisions about its future use. The proposed study is feasible because our partners include two large, national health plans, we will leverage an existing FDA sentinel infrastructure, and we have a strong, multidisciplinary research team.

Transactions

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Subawards

Subrecipient Amount Awarded
New England Research Institutes Inc. 1. Contracting, legal, and IRS approval Participating DP will obtain the regulatory approvals necessary for conducting the intervention using a centralized IRS.… $9,000
Humana Healthcare Research Inc. $116,542
University Of California, LOS Angeles Dr. Reuben's primary responsibilities will include serving as a co•investigator on the D-PRESCRIBE study team and providing input on the educational… $20,377
Harvard Pilgrim Health Care, Inc. Harvard Pilgrim Health Care (HPHC) will conduct the following activities as an active participant in the D-PRESCRIBE-AD study. HPHC will be responsible for… $179,420
New England Research Institutes Inc. 1. Contracting, legal, and IRS approval Participating DP will obtain the regulatory approvals necessary for conducting the intervention using a centralized IRS.… $145,928
Humana Healthcare Research Inc. $141,931

Quick answers

Who received award R33AG069794?

R33AG069794 was awarded to University Of Massachusetts Medical School by National Institute on Aging (National Institutes of Health) on September 30, 2020.

How much is award R33AG069794 worth?

$7,241,890 has been obligated on R33AG069794: $6,189,567 in federal funding and $1,052,323 in non-federal funding.

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