Medication Review in Cognitive Impairment and Dementia
We have developed the Medication Review in Cognitive Impairment and Dementia (MedRevCiD) Checklist to guide a focused and comprehensive medication review in individuals with cognitive impairments and dementia.
Stakeholder Storytelling, Prioritizing Questions about Medication Use in Dementia and Determining Barriers and Facilitators of Medication Reviews
Impact of Medication Reviews on clinical outcomes in persons with Dementia
We conducted a scoping review to identify gaps in current knowledge about the impact of medication. We found gaps in studies examining quality of life, mortality, medication management, and medication adherence as an outcome of medication reviews.
Medication Review in Cognitive Impairment and Dementia: Comparison of Instruments
This study aims to identify drug-related problems in older adults with cognitive impairment or dementia using two tools. We will compare Medication Review in Cognitive Impairment and Dementia (MedRevCiD) checklist with the Medication appropriateness index (MAI) to identify drug-related problems in older adults with cognitive impairment or dementia receiving care at primary care.
The content of the MedRevCiD Checklist was validated with subject matter expert through a Delphi Consensus study.
We are currently testing the feasibility, practicality, and perceived effectiveness of the MedRevCiD, as well as the barriers and facilitators for its implementation in MINT memory clinics.
Related Posters, Presentations, & Publications
Lee L, Locklin J, Patel T, Lu SK, Hillier LM. Recruitment of participants for dementia research: Interprofessional perspectives from primary-care based memory clinics. Neurodegenerative Disease Management. 2022; 12.
Lee L, Patel T, Molnar F, Seitz D. Optimizing medications in older adults with cognitive impairment : Considerations for primary care clinicians. Can Fam Physician 2018; 64: 646 – 652.
Patel T, Slonim K, Lee L. Use of potentially inappropriate medications among ambulatory home-dwelling elderly patients with dementia: A review of the literature. Can Pharm J 2017; 150: 169 – 183.
Duong S, Patel T, Chang F. Dementia: What pharmacists need to know. Can Pharm J 2017; 150: 118 – 129.
Chang F, Patel T, and Schulz ME. The “Rising Tide” of dementia in Canada: what does it mean for pharmacists and the people they care for? Can Pharm J 2015; 148: 193 – 199.
Rojas-Fernandez C, Patel T and Lee L. An interdisciplinary memory clinic: a novel practice setting for pharmacists in primary care in Ontario, Canada. Ann Pharmacother 2014; 48; 785 - 795.
Patel T. Should the Window for Intravenous Administration of Tissue Plasminogen Activator in the Treatment of Acute Ischemic Stroke be Extended to 4.5 Hours? Can J Hosp Pharm 2009; 62: 248 – 249.
Participants from a variety of backgrounds and disciplines came together in a hybrid meeting where they had the opportunity to share their experiences regarding medication use. This open-ended discussion gave participants a foundation to help contextualize the problems and benefits of medication reviews.
Using a nominal group technique process, participants were first separated into groups of pharmacists, care partners and health care professionals. They were then asked to develop ideas for "What are the most relevant questions to ask about assessing medication use and reviews in persons with cognitive impairment and dementia?" which were shared with the rest of the group. Ultimately, the questions were grouped into themes that participants ranked based on relevance. The top ranked themes and questions are considered to be prioritized through this exercise.
To further develop the research agenda for medication reviews, we had a semi-structured discussion with the groups of participants to inform what potential facilitators and barriers exist in the process of doing studies on medication review and use.