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A recent study conducted by researchers at UMass Chan Medical School has shown that mailing educational materials to Alzheimer’s patients, caregivers, and doctors had no significant impact on reducing the prescription of risky drugs for dementia patients. The study, published in JAMA Internal Medicine, aimed to address the dangers of prescribing certain high-risk medications to people with Alzheimer’s disease or other forms of dementia, who are often more susceptible to adverse side effects.
The study, led by Dr. Jerry H. Gurwitz, a professor of primary care medicine and a geriatric expert, targeted the reduction of antipsychotics, sedative-hypnotics, and strong anticholinergics—medications known for their potential risks in elderly dementia patients. Older adults with dementia frequently receive multiple medications, which compounds the risk of negative side effects. By mailing information about these risks to doctors, patients, and caregivers, researchers hoped to influence prescription habits and improve safety.
Known as D-PRESCRIBE-AD (Developing a Program to Educate and Sensitize Caregivers to Reduce the Inappropriate Prescription Burden in Elderly with Alzheimer’s Disease), the trial included close to 13,000 people with dementia, all enrolled in two national health plans. The participants were divided into three groups: one group in which only doctors received a mailing about high-risk drugs, a second group where doctors, patients, and caregivers all received the educational materials, and a third group that received no mailings at all, continuing with standard care practices.
Despite efforts to raise awareness through mailed information, the study found that the mailings had no effect on reducing risky prescriptions. Dr. Gurwitz explained that mailings are a common way for health plans to communicate important health issues to both patients and doctors. However, he noted, letters to busy clinicians often arrive “out of context” and may not be impactful, especially given the challenges of balancing daily workloads.
Hopefully, patients or their caregivers would use this information to discuss safer treatment options with their doctors, but the study observed that this rarely occurred. Interestingly, about one in five patients stopped taking the high-risk drugs, but this rate was the same across all groups, regardless of whether they received the mailings or not. This finding underscored that the letters did not make a measurable difference. told by Mayo Clinic.
Dr. Gurwitz emphasized the importance of understanding the efficacy of such interventions. “It’s an important challenge, and they need to figure out a better way,” he said. The study highlighted that simple information mailings might be insufficient and suggested that more interactive strategies could be beneficial. For instance, similar studies conducted in Canada that included pharmacists working directly with patients showed more promising outcomes, suggesting that healthcare provider involvement beyond mailed materials may be essential for effective change.
As Dr. Gurwitz and his team continue their research, they aim to develop more effective approaches for reducing unsafe prescriptions, working closely with national health plans to find methods that protect vulnerable older adults from high-risk medications.
