# Developing a PRogram to Educate and Sensitize Caregivers to Reduce the Inappropriate Prescription Burden in Elderly with Alzheimer's Disease Study (D-PRESCRIBE-AD)

> **NIH NIH R33** · UNIV OF MASSACHUSETTS MED SCH WORCESTER · 2022 · $901,588

## Abstract

PROJECT SUMMARY/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 m...

## Key facts

- **NIH application ID:** 10469002
- **Project number:** 5R33AG069794-03
- **Recipient organization:** UNIV OF MASSACHUSETTS MED SCH WORCESTER
- **Principal Investigator:** JERRY H GURWITZ
- **Activity code:** R33 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $901,588
- **Award type:** 5
- **Project period:** 2020-09-30 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10469002

## Citation

> US National Institutes of Health, RePORTER application 10469002, Developing a PRogram to Educate and Sensitize Caregivers to Reduce the Inappropriate Prescription Burden in Elderly with Alzheimer's Disease Study (D-PRESCRIBE-AD) (5R33AG069794-03). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10469002. Licensed CC0.

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