# Optimal Medication Management in Alzheimer's Disease and Dementia

> **NIH NIH R33** · KAISER FOUNDATION RESEARCH INSTITUTE · 2021 · $619,216

## Abstract

PROJECT SUMMARY:
The vast majority of individuals with Alzheimer's disease and related dementias (ADRD) have multiple chronic
conditions (MCC). The combination of ADRD plus other conditions (ADRD-MCC) leads to more medication
use, more complex medication regimens for patients, and is associated with greater risk of adverse drug
events, drug interactions, treatment burden and cognitive changes in addition to higher rates of hospitalization
and mortality. Optimizing medication through deprescribing (the process of reducing or stopping the use of
inappropriate medications or medications unlikely to be beneficial) can help avoid adverse drug effects and
improve outcomes for MCC patients, particularly for those with ADRD. Deprescribing is a nascent field in the
U.S. that is likely to have a significant positive impact over the next decade if properly developed and
implemented. We propose a project to refine and test a pragmatic deprescribing intervention for people with
ADRD-MCC so that these patients are on “just right” medication regimens. Our overall goal for the project is to
refine and test a patient- and family/caregiver- centric deprescribing intervention that is applicable to multiple
medications and can be adapted to a variety of healthcare delivery settings.
The intervention will target older adults with ADRD-MCC on 5 or more medications and their family caregivers
and deliver the intervention at Kaiser Permanente Colorado (KPCO), a not-for-profit integrated delivery system.
Aims 1 and 2 will focus on engaging patients, family/ caregivers, clinicians and health system stakeholders to
enhance, refine, and pilot test the intervention. Aims 3 and 4 will test the effectiveness of the intervention in
reducing number of chronic medications and number of potentially in appropriate medications as well
secondary outcomes of patient falls, adverse drug events, hospital and skilled nursing facility utilization,
activities of daily living, and outpatient office visit length. Aim 5 will qualitatively explore mechanisms behind
intervention effectiveness.
The proposed project will demonstrate the potential to implement sustainable changes in medication
management to improve the health and safety of patients with ADRD receiving treatment for comorbid
conditions with multiple medications. It will be adaptable to other delivery systems and settings, and is
designed to foster a culture of thoughtful medication decision-making acceptable to ADRD-MCC patients,
caregivers, and their clinicians.

## Key facts

- **NIH application ID:** 10104414
- **Project number:** 5R33AG057289-05
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** ELIZABETH A BAYLISS
- **Activity code:** R33 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $619,216
- **Award type:** 5
- **Project period:** 2017-09-30 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10104414

## Citation

> US National Institutes of Health, RePORTER application 10104414, Optimal Medication Management in Alzheimer's Disease and Dementia (5R33AG057289-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10104414. Licensed CC0.

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