An educational mailer sent to doctors and people with Alzheimer’s disease or related dementias about reducing unneeded or potentially harmful prescription drugs didn’t lower the use of these medications, a new study shows.
The report was published Monday in JAMA Internal Medicine.
People with forms of dementia may be more likely to take antipsychotics, sedative-hypnotics and strong anticholinergic drugs. These can be potentially inappropriate if patients no longer need them. These medications also can increase the risk of harm to the patient in general.
Researchers wanted to see if a printed mailer would encourage patients to talk with their doctors about deprescribing medications, or encourage doctors to have those conversations with patients.
The trial included 12,787 patients with Alzheimer’s disease or a related dementia who were enrolled in two large national health plans, and who were taking any one of the three classes of drugs targeted for reduced use.
The team sent one-time mailers to two separate groups: The first group included patients and their prescribing clinicians; the second group included their doctors only. A third group received their usual care without a mailing.
During the study, the prevalence of potentially inappropriate medications and the risk of mortality was about the same in all groups. At the end of the six-month study, 76.7% in the first group were still on a medication that was targeted for deprescribing, 77.9% in the second group were on such a medication, and 77.5% in the usual care group were on targeted medications. There was also no difference in the dose patients took of these drugs.
“These findings suggest medication-specific educational mailings targeting patients with Alzheimer’s disease or Alzheimer’s disease and related dementias and their clinicians are not effective in reducing the use of high-risk medications,” the authors wrote.
