Evidence map›Paper›PMID 36331050›Full record

Trial reportAlzheimer's & dementia : the journal of the Alzheimer's Association2023

Effect of collaborative dementia care on potentially inappropriate medication use: Outcomes from the Care Ecosystem randomized clinical trial.

Amy K Liu, Katherine L Possin, Kristen M Cook, Shalini Lynch, Sarah Dulaney, Jennifer J Merrilees, Tamara Braley, Rachel E Kiekhofer, Stephen J Bonasera, Isabel E Allen and 8 more

3 registry-linked trialsAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 14 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02213458 nacompletednot on this map

University of California, San Francisco (UCSF) and University of Nebraska Medical Center (UNMC) Care Ecosystem

TypeinterventionalSponsorUniversity of California, San FranciscoRan2015 to 2018Enrolled1,560ConditionsDementia, Alzheimer Disease, Dementia, Vascular, Lewy Body DiseaseArmsNavigated Care
NCT04287738 nacompletednot on this map

Care Ecosystem: Navigating Patients and Families Through Stages of Care, Extension Trial

TypeinterventionalSponsorUniversity of California, San FranciscoRan2015 to 2022Enrolled912ConditionsDementia, Alzheimer Disease, Dementia, Vascular, Lewy Body DiseaseArmsNavigated Care
NCT05669365 nacompletednot on this map

The Care Ecosystem Consortium Effectiveness Study

TypeinterventionalSponsorUniversity of California, San FranciscoRan2023 to 2025Enrolled1,227ConditionsDementia, Dementia, Vascular, Dementia With Lewy Bodies, Dementia AlzheimersArmsCare Ecosystem
3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Long-term effects of collaborative dementia care on quality of life and caregiver well-being.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
    Trial
  6. Article
  7. Dissemination of the Care Ecosystem Collaborative Care Model for Dementia.Journal of the American Geriatrics Society · 2025
    Article
  8. Article
  9. Review
  10. Article
  11. Observational
  12. Article
  13. Article
  14. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Amy K LiuDepartment of Clinical Pharmacy, University of California, San Francisco, California, USA.
Katherine L PossinMemory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, California, USA.
Kristen M CookDepartment of Pharmacy Practice and Science, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Shalini LynchDepartment of Clinical Pharmacy, University of California, San Francisco, California, USA.
Sarah DulaneyMemory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, California, USA.
Jennifer J MerrileesMemory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, California, USA.
Tamara BraleyDivision of Geriatrics, Gerontology, and Palliative Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Rachel E KiekhoferMemory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, California, USA.
Stephen J BonaseraDivision of Geriatrics, Gerontology, and Palliative Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Isabel E AllenDepartment of Epidemiology and Biostatistics, University of California, San Francisco, California, USA.
Winston ChiongMemory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, California, USA.
Amy M ClarkDivision of Geriatrics, Gerontology, and Palliative Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Julie FeuerMemory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, California, USA.
Joan EwaltDivision of Geriatrics, Gerontology, and Palliative Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Elan L GutermanMemory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, California, USA.
Rosalie GearhartMemory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, California, USA.
Bruce L MillerMemory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, California, USA.
Kirby P LeeDepartment of Clinical Pharmacy, University of California, San Francisco, California, USA.

Funding

Research Education ComponentP30AG062422 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Katherine Laurel Possin · 2019 to 2026
$36.9M
The Care Ecosystem Response to COVID-19: Accelerating Research on Dementia Care that Meets the Needs of Caregivers and Persons with Dementia during COVID-19R01AG074710 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI POSSIN, KATHERINE LAUREL · 2022 to 2024
$9.1M
CLINICAL, PHARMACOLOGY, DRUG ACTION &PHARMACOKINETICST32GM007546 · NIGMS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Radojka Savic · 1985 to 2026
$8.9M
The Care Ecosystem: Navigating patients and caregivers through stages of dementia careR01AG056715 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI POSSIN, KATHERINE LAUREL · 2017 to 2021
$6.0M
Prehospital Management of Status EpilepticusK23NS116128 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GUTERMAN, ELAN · 2020 to 2024
$1.1M
NIA NIH HHS P30 AG062422NIA NIH HHS R01 AG056715NIA NIH HHS R01 AG074710NIGMS NIH HHS T32 GM007546NINDS NIH HHS K23 NS116128
6 · The paper itself

Abstract

introductionPotentially inappropriate medications (PIMs) cause adverse events and death. We evaluate the Care Ecosystem (CE) collaborative dementia care program on medication use among community-dwelling persons living with dementia (PLWD).

methodsSecondary analysis of a randomized clinical trial (RCT) comparing CE to usual care (UC) on changes in PIMs, over 12 months between March 2015 and May 2020. Secondary outcomes included change in number of medications, clinically relevant PIMs, and anti-dementia medications.

resultsOf 804 PLWD, N = 490 had complete medication data. The CE resulted in significantly fewer PIMs compared to UC (-0.35; 95% CI, -0.49 to -0.20; P < 0.0001). Number needed to prevent an increase in 1 PIM was 3. Total medications, PIMs for dementia or cognitive impairment, CNS-active PIMs, anticholinergics, benzodiazepines, and opioids were also fewer. Anti-dementia medication regimens were modified more frequently.

conclusionThe CE medication review intervention embedded in collaborative dementia care optimized medication use among PLWD. HIGHLIGHTS: Compared to usual care (UC), the Care Ecosystem (CE) medication review intervention prevented increases in potentially inappropriate medications (PIMs). Use of anticholinergics, benzodiazepines, and opioids were significantly reduced, with a trend for antipsychotics. Anti-dementia medications were adjusted more frequently. The CE medication review intervention embedded in collaborative dementia care optimized medication use.

Indexed as

Inappropriate PrescribingPotentially Inappropriate Medication ListBenzodiazepinesCholinergic AntagonistsHumansIndependent LivingPolypharmacyBenzodiazepinesCholinergic Antagonistsanti-dementia medicationsdementiamedication reviewpharmacistpolypharmacypotentially inappropriate medications

Identifiers

PMID36331050
PMCPMC10156873

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.