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NCT Number: NCT07454824

e-ALIGN: A Patient Portal-based Intervention to Align Medications With What Matters Most

The overarching goal of this study is to pilot an intervention in which older adults with mild cognitive impairment and dementia and the older adult's care partners are identified in primary care and provided with educational materials through the patient portal to engage the participant in deprescribing. The multicomponent intervention, e-Align, includes delivery of educational information through the patient portal, and a pharmacist-led intervention to align medications with patient and care partner goals and reduce use of central nervous system (CNS) potentially inappropriate medicines (PIM). This work will establish the preliminary data, methods, and partnerships to undertake a multisite embedded pragmatic clinical trial. The resulting triadic-based behavioral intervention will promote patient and care partner engagement, and foster care that aligns with patients' values, and promote improved health and well-being outcomes for people with cognitive impairment and the patient's care partners through deprescribing.

Recruiting

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Key information

Conditions

Dementia Brain Diseases Central Nervous System Diseases Cognition Disorders Cognitive Dysfunction Mental Disorders Mild Cognitive Impairment (MCI) Nervous System Diseases Neurocognitive Disorders Potentially Inappropriate Medication Use

Age range

65 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Johns Hopkins Community Physicians

Baltimore, Maryland, 21209, United States

Location status: Recruiting

Location contact

Ariel Green, MD, MPH, PhD

CONTACT

CONTACT

[email protected]

410-550-6733

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients: Age ≥65, with a diagnosis of MCI or dementia based on ICD-10 codes and ≥1 active CNS-PIM, who are active patient portal users.

Care partners:

  • Family or other companions >21 years who regularly help the patient with managing medications.

Exclusion criteria

  • As the trial will be based in primary care, individuals residing in long term care facilities or enrolled in hospice will be excluded.

Treatment and study plan

e-ALIGN Patient-Portal Deprescribing

Other

The intervention will consist of educational materials about deprescribing, which will be sent to the patient prior to the scheduled primary care visit.

Primary outcomes

  1. Number of patients who open the patient portal message

    Time frame: 1 month after sending message

    The investigators will assess the number of patients and/or care partners who read the patient portal message sent by the study team, which invites the participant to meet with a clinical pharmacist for deprescribing.

  2. Number of patients who watch the video

    Time frame: 1 month after sending message

    The investigators will assess the number of patients who click and watch the educational video about CNS-PIM and deprescribing.

  3. Acceptability of educational video assessed by survey

    Time frame: 1 month after sending message

    The investigators will assess the acceptability of the educational video by administering a survey to participants. The survey will ask participants to rate various features of the video on a 5-point Likert scale, where a higher score indicates greater acceptability.

Secondary outcomes

  1. Number of patients or care partners that discussed deprescribing with any clinicians after receiving the message

    Time frame: 3 months after sending message

    Study team will follow up to assess if deprescribing was discussed with a clinician after receiving the patient portal message by conducting a review of patients' chart.

  2. Number of PCPs who send the referral

    Time frame: 3 months after sending message

    Study team will assess how many PCPs send a referral to clinical pharmacy for patients who have been identified as candidates for deprescribing.

  3. Number of patients who schedule the pharmacist visit

    Time frame: 3 months after sending message

    The investigators will determine the number of patients and/or care partners who schedule a visit with a clinical pharmacist for deprescribing CNS-PIM following receipt of the patient portal message.

  4. Number of patients who deprescribe ≥1 CNS-PIM after receiving the message

    Time frame: 3 months after sending message (for patients who do NOT have a pharmacist visit)

    For those who do not schedule a pharmacist visit, the investigators will evaluate the number of patients who deprescribed at least 1 CNS-PIM after receiving the patient portal message.

  5. Number of patients who start ≥1 CNS-PIM after receiving the message

    Time frame: 3 months after sending message (for people who do NOT have a pharmacist visit)

    For those who do not schedule a pharmacist visit, the investigators will evaluate the number of patients who add at least 1 CNS-PIM to the medication regimen after receiving the patient portal message.

Study contacts

Contact information is provided by the study sponsor or research team.

Ariel Green, MD, MPH, PhD

CONTACT

[email protected]

410-550-6733

Sponsors and collaborators

Lead sponsor

Johns Hopkins University

Other

Collaborators

  • National Institute on Aging (NIA)

Registry information

Acronym: e-ALIGN

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Mar 6, 2026
Registry last updated
Jun 16, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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