Integrated Dementia Care Reduces Unnecessary Medications, Study Finds

A recent study presented at the 2024 Annual Scientific Meeting of the Gerontological Society of America indicates that merging primary care with dementia care can significantly reduce the prescribing of unnecessary and potentially harmful medications. Researchers from the Integrated Memory Care Center (IMCC) at Emory University in Atlanta, Georgia, revealed that their coordinated approach allows clinicians to better manage the complex health conditions often present in dementia patients while minimizing the risks associated with certain drugs.

A New Era of Dementia Care

The study involved a comprehensive analysis of 1,508 patients aged 65 and older with a dementia diagnosis who received care at Emory Healthcare between 2019 and 2021. Of these, 509 were treated at the IMCC; 490 received care at separate cognitive neurology (CN) and primary care (PC) clinics; and 509 were treated solely in primary care settings.

Findings showed that patients at the IMCC had higher rates of deprescribing potentially dangerous medications, including high-dose antipsychotics, benzodiazepines, and opioids, compared to those receiving care at standalone clinics. Specifically, patients at the IMCC had 4.38 times the odds of being deprescribed high-dose antipsychotics relative to the CN group, 3.33 times for benzodiazepines, and 1.00 for opioids. When compared to the PC-only group, the odds increased even further, with a 5.54 chance for antipsychotics and 2.63 for benzodiazepines noted.

“We support the idea that having a coordinated, comprehensive approach to dementia care is beneficial,” said Laura Medders, LCSW, program director at IMCC. “We’re looking at all of their health conditions through the lens of their dementia diagnosis.”

Addressing Comorbid Conditions

The potential risks of inappropriate prescribing for dementia patients cannot be overstated. The combination of dementia and other comorbid conditions often results in adverse health outcomes, such as increased mortality rates, falls, and hospitalizations. Alarmingly, rates of preventable hospitalizations among adults over 65 with dementia are increasing, leading to complications like unintended secondary consequences when patients do not leave hospitals in the same state they entered.

Medders emphasized the role of IMCC in addressing these issues. “Integrated care better addresses the complex nature of comorbid conditions. Geriatric conditions do not live apart from the dementia diagnosis; they influence each other,” she stated.

The IMCC also employs strategies to reduce unnecessary hospital visits, including an after-hours phone line for caregiver support. This initiative not only alleviates caregiver burdens but potentially prevents avoidable hospital admissions, which can be disruptive for families already faced with financial strains.

Expert Insights

Kemi Reeves, associate director of the UCLA Alzheimer’s and Dementia Care Program, echoed the findings of the IMCC team. “Integrated care models provide a more effective approach to managing older adults’ broader health issues,” she noted. Meanwhile, Michal Schnaider Beeri, PhD, director of the Herbert and Jacqueline Krieger Klein Alzheimer’s Research Center, praised IMCC’s model, calling it “promising with the potential to significantly improve outcomes and quality of life for both patients and caregivers.”

However, Beeri acknowledged a crucial caveat, stating that “widespread adoption would require changes in insurance coverage and healthcare delivery systems.”

The Path Forward

The benefits of integrated dementia care as indicated by this pivotal study highlight a crucial shift needed within healthcare systems. With rising demands for effective treatment methods in geriatric care, establishing integrated programs like IMCC may become essential for addressing the intricate interplay between dementia and other health issues.

This research not only provides a framework for future studies but also has significant implications for the healthcare technology sector. As the demand for efficient and effective care solutions grows, innovations that facilitate integrated approaches will likely become increasingly relevant.

For more insights into how technology intersects with advancements in healthcare, visit our other articles on emerging healthcare technologies.

What are your thoughts on this integrated approach to dementia care? Have you or someone you know experienced the impacts of medication management in older adults? Join the discussion in the comments below!

What are⁣ the potential barriers to adopting integrated dementia care systems in healthcare?

Editor’s Note: This interview is based on a recent study presented at the 2024 Annual Scientific Meeting of the Gerontological Society of America. The findings suggest that merging primary care with dementia care can significantly ⁤reduce the prescribing of ​unnecessary medications and potentially harmful drugs in patients aged 65 and older‌ with⁤ dementia diagnosis. The focus of ⁢this discussion is on the⁣ benefits of⁢ integrated dementia care, challenges and opportunities for its widespread adoption, and the potential impact on healthcare delivery systems and technology.

Guest 1: Laura Medders, LCSW, Program Director ​at Integrated‍ Memory Care Center (IMCC)

Guest 2: Kemi Reeves, Associate Director of the UCLA Alzheimer’s and Dementia Care ⁢Program

Interviewer: Hello, Laura and Kemi. Thank you for joining us today. Let’s dive straight in. Laura, can you please explain the concept behind integrated dementia care and⁤ its potential ⁣benefits?

Laura Medders: Sure. Integrated dementia care involves bringing together the expertise of primary care providers and specialists in dementia care to address the complex health needs of patients diagnosed with dementia. This coordinated approach‍ helps us better manage ⁢their various health‌ conditions while minimizing the risks associated with certain medications. Our recent study showed that patients treated at the IMCC had higher rates of‌ deprescribing potentially dangerous medications like high-dose antipsychotics, benzodiazepines, ⁣and ⁢opioids compared to those receiving care at‍ separate clinics or only in primary care settings. This suggests that integrated care can improve patient outcomes by reducing the risk of adverse effects from these drugs.

Interviewer: That’s fascinating. Kemi, what are your thoughts on integrated dementia care, and how does it differ from traditional models of ⁢care?

Kemi Reeves: Integrated⁤ care models ⁢provide a more holistic approach to managing older adults’ health issues, considering the broader context of​ their conditions rather ‍than addressing ​them in isolation. Traditional models often focus on specific aspects of⁤ healthcare, such as treating cognitive impairment or managing physical symptoms. However, dementia is‍ a progressive disease that ⁢affects multiple ‌aspects of