# Deprescribing for Post-Acute Care Older Patients with Dementia in Home Health Care

> **NIH NIH K76** · UNIVERSITY OF ROCHESTER · 2024 · $243,000

## Abstract

PROJECT SUMMARY/ABSTRACT
Older persons with Alzheimer’s disease and related dementias (ADRD) often use potentially inappropriate
medications (PIMs) - medications with a risk of harm or that are unlikely to be beneficial. The use of PIMs
leads to accelerated functional decline, hospitalization, institutionalization, and death, yet it is difficult to
appropriately deprescribe (discontinue/reduce) these medications, especially during the post-acute care
transitions when PIM use is common and has substantial consequences. Current research in deprescribing for
persons with ADRD has focused on long-term care, with a critical gap in our understanding of deprescribing in
routine clinical practice for community-dwelling older adults with ADRD during care transitions. In this study, we
focus on home health care (HHC) - a logical setting to address PIM use and deprescribing in persons with
ADRD during post-acute care transitions due to its existing care processes, clinician workforce, and resources
that can serve as a foundation to deprescribing of PIMs. This 5-year project includes two aims. Aim 1 is to
identify the factors associated with, and novel barriers/facilitators in, routine practice PIM deprescribing among
persons with ADRD in HHC. We will use a sequential mixed methods approach, including analysis of existing
data in national administrative service datasets and qualitative stakeholder engagement through group concept
mapping. Then, we will integrate and synthesize the results from quantitative data analysis and qualitative
stakeholder engagement to further develop a deprescribing intervention in HHC for older adults with ADRD
and caregivers. Aim 2 is to test the feasibility, acceptability, and preliminary effects of the intervention in a one-
group pre-post clinical trial. This proposal is aligned with NIA’s strategic priorities to develop innovative
interventions to target multimorbidity and its associated geriatric syndromes (e.g., polypharmacy), and to
support older persons with ADRD through care and services provided at home and in the community. Findings
will form the basis for a subsequent R01 that will examine the effects of the developed deprescribing
intervention on medication and clinical outcomes of older HHC patients with ADRD. The candidate, Dr. Jinjiao
Wang, Ph.D., RN, is a registered nurse with experience in HHC and an assistant professor at the University of
Rochester (UR) School of Nursing. The long-term goal of Dr. Wang is to become a leading geriatrics health
services researcher in home-based geriatric care with a focus on medication safety and optimization. Under a
multidisciplinary team of exemplary mentors from medicine, psychiatry, psychology, nursing, and gerontology,
and clinical pharmacy, Dr. Wang will build on her preliminary work on polypharmacy management in HHC to
accomplish training goals in ADRD care, mixed methods approach, design and conduct of clinical trials,
particularly with persons with ADRD and their careg...

## Key facts

- **NIH application ID:** 10937257
- **Project number:** 1K76AG083276-01A1
- **Recipient organization:** UNIVERSITY OF ROCHESTER
- **Principal Investigator:** Jinjiao Wang
- **Activity code:** K76 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $243,000
- **Award type:** 1
- **Project period:** 2024-08-21 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10937257

## Citation

> US National Institutes of Health, RePORTER application 10937257, Deprescribing for Post-Acute Care Older Patients with Dementia in Home Health Care (1K76AG083276-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10937257. Licensed CC0.

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