Reducing Risk of Dementia through Deprescribing: Cognitive Outcomes After AntiCholinergic Reduction (R2D2: COACH)
M
Malaz Boustani, MD
Primary Investigator
N
Noll Campbell
Primary Investigator
Overview
This study will evaluate the effects of the use of a program to reduce prescribing of a group of commonly prescribed medications called anticholingerics that may adversely effect cognitive functioning in older adults.
Eligibility
You may be eligible for this study if you meet the following criteria:
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Conditions:
Dementia
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Age: Between 65 Years - 100 Years
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Gender: All
Inclusion Criteria
At least one office visit to their primary care physician within the previous 12 months;
At least one order for a strong anticholinergic medication in the previous 12 months
Subjective cognitive dysfunction by meeting either (a) or (b) of the following criteria:
a. A response of “somewhat worse” or “much worse” to the SCD screening question: “In general, how would you describe your memory as compared to 10 years ago? Response offerings are: much better / somewhat better / about the same / somewhat worse / much worse.
b. A score of 5 or less on the Six-Item Screener (SIS).98 The SIS is a global measure of cognitive status that assesses three-item recall and orientation to year, month, and day of the week.
Able to communicate in English;
Access to a telephone
At least one order for a strong anticholinergic medication in the previous 12 months
Subjective cognitive dysfunction by meeting either (a) or (b) of the following criteria:
a. A response of “somewhat worse” or “much worse” to the SCD screening question: “In general, how would you describe your memory as compared to 10 years ago? Response offerings are: much better / somewhat better / about the same / somewhat worse / much worse.
b. A score of 5 or less on the Six-Item Screener (SIS).98 The SIS is a global measure of cognitive status that assesses three-item recall and orientation to year, month, and day of the week.
Able to communicate in English;
Access to a telephone
Exclusion Criteria
Permanent resident of an extended care facility (nursing home)
Diagnosis of schizophrenia, bipolar disorder, or schizoaffective disorder defined by ICD9/10 codes
Diagnosis of ADRD as determined by either:
a. ICD-9/ICD10 codes, or
b. Current use of a medication for ADRD, or
c. SIS score less than 3
d. Functional Activities Questionnaire (FAQ) score greater than 7 indicating ADRD Used by itself, the FAQ has a sensitivity of 0.85 and specificity of 0.81 for the diagnosis of ADRD. When used in conjunction with a cognitive screening tool, such as the SIS, specificity improves to 0.89 with sensitivity of 0.91 for the diagnosis of ADRD.
Diagnosis of schizophrenia, bipolar disorder, or schizoaffective disorder defined by ICD9/10 codes
Diagnosis of ADRD as determined by either:
a. ICD-9/ICD10 codes, or
b. Current use of a medication for ADRD, or
c. SIS score less than 3
d. Functional Activities Questionnaire (FAQ) score greater than 7 indicating ADRD Used by itself, the FAQ has a sensitivity of 0.85 and specificity of 0.81 for the diagnosis of ADRD. When used in conjunction with a cognitive screening tool, such as the SIS, specificity improves to 0.89 with sensitivity of 0.91 for the diagnosis of ADRD.
Updated on
02 May 2024.
Study ID: 1706800075
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