Medication Empowerment and Deprescription for Safety (MEDS) Study

Completed · Not applicable

Conditions studied: Aging, Fall Injury

In brief

The long-term goal of this pragmatic, cluster randomized study is to develop a sustainable program for healthcare systems to reduce fatal and nonfatal falls among high-risk older adults living independently in their communities. This study will examine how a medication care plan, grounded in established medication deprescribing and tapering frameworks, can be implemented in primary care clinics to reduce falls among older adults living in rural Iowa communities. The study is a collaboration between researchers and clinical pharmacists at the University of Iowa and a clinical team from the MercyOneSM Health Network, which is a non-academic healthcare system with significant reach into rural Iowa communities The study's specific goals are as followed: * Aim 1: Examine the effectiveness of a clinic-based, individualized medication care plan in reducing rates of all falls including medically treated falls (sub-aim 1a) and motor vehicle charges and crashes (sub-aim 1b) among older adults seen in rural primary care clinics. * Aim 2: Identify provider and patient factors that are associated with patient adherence to medication deprescribing and discontinuation recommendations. * Aim 3\*: Evaluate implementation of the medication care plan to understand its acceptability, usability and relevance among healthcare system administrators, clinics (clinic managers and clinical staff), providers (health coaches, pharmacists, prescribers) and participants. Note\*: Only Aims 1 and 2 (i.e., pertinent to the clinical trial) will be described in this clinicaltrials.gov study description. Intervention and control participants will participate in: * Baseline assessment * Quarterly follow-up assessments * Monthly falls tracking Additionally, intervention participants will receive: • An individualized medication action plan to deprescribe medications that put them at high risk for a fall Researchers will compare intervention and control participants for changes in self-reported fall rates (primary outcome), EMR-indicated medically-treated falls (secondary outcome), traffic-related charges (secondary outcome), and motor vehicle crashes (secondary outcome).

Key facts

Study ID

NCT04612166

Run by

University of Iowa

People needed

398

Starts

2020-08-01

Expected to finish

2024-06-30

Last updated by the study team

2026-05-13

Who can join

Age: 60 and older, up to 110. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• 60 years of age
• Speaks English
• Lives independently in the community (not in assisted living, skilled nursing, rehabilitation facility or hospice)
• Currently taking at least one medication (prescription or OTC) regularly (at least once a week) that puts an older adult at high risk for a fall and plan on taking the medication for at least the next month
• Receives most medical care at a MercyOne clinic

You may not qualify if…

• Does not meet inclusion criteria
• Alzheimer's diagnosis
• Receiving treatment for active cancer

Where it is running

• MercyOne Population Health Services — Clive, Iowa, United States

Full record on ClinicalTrials.gov

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