Medication Therapy Management for Older Adults

The INCREASE study was a randomized controlled trial enrolling community-dwelling adults 65 years and older who did not have dementia and were using at least one PIM as defined in the 2015 Beers Criteria (the most recent version at the time of the study) [13 ]. Complete details of the INCREASE protocol and results are available elsewhere and briefly described below [11 (link), 12 (link)]. After 1:1 randomization that was stratified based on baseline amyloid burden, participants randomized to the control group received usual care with educational pamphlets on medication appropriateness for older adults and risks associated with polypharmacy. In addition to educational materials, participants randomized to the MTM intervention met with the BCGP and a non-pharmacist study clinician (e.g., nurse practitioner, neurologist) to discuss the baseline recommendations. This meeting allowed for 1) participant education on risks, benefits, and alternatives to optimize medication use; and 2) the collection of additional relevant information, including participant beliefs, preferences, and treatment goals. During the MTM team meeting, final recommendations were formalized, and the details of any relevant revisions to the baseline recommendation were noted in the pre-specified data collection forms.
The INCREASE study was approved by the University of Kentucky Institutional Review Board (IRB #43239) and all the study participants provided informed consent. The protocol for the study was registered on clinicaltrials.gov (NCT02849639) on 29/07/2016, in accordance with the relevant guidelines and regulations or in accordance with the Declaration of Helsinki. Study data were collected and managed using the Research Electronic Data Capture (REDCap), a secure, web-based software platform designed to support data capture for research studies [14 (link), 15 (link)].