Medication appropriateness tool for co‐morbid health conditions in dementia criteria
The Medication Appropriateness Tool for Comorbid Health conditions during Dementia (MATCH-D) criteria supports clinicians to manage medication use specifically for people with dementia without focusing only on the management of the dementia itself.[1][2]
History
The MATCH-D were developed by medical practitioners and pharmacists at Australian Group of Eight Universities. It was led by Dr Amy Theresa Page at the Western Australian Centre for Health and Ageing at the University of Western Australia. The MATCH-D Criteria were developed through a consensus panel of experts using the Delphi method. The criteria were originally published in the Internal Medicine Journal in 2016.[2] The protocol explaining the rigorous methods used to develop the criteria were originally published in the BMJ Open in 2015.,[3] and the systematic review that informed the criteria were published subsequently.[4]
Style of the criteria
The MATCH-D is presented in categories of recommendations for all stages of dementia, as well as divided into specific recommendations for early, mid and late-stage dementia. The recommendations are groups as: medication side effects, principles for medication use, medication review, treatment goals, preventative medications, symptom management, psycho-active medications, medications to modify dementia progression.
Reception of the criteria
The MATCH-D attracted media attention as it was under development, and as it was released. Page was interviewed on the ABC national radio's science show during its development.[5] The health media picked up the story as soon as it was published.[6]
Uses
Consumers considered the MATCH-D to be a useful tool for prompting and supporting conversations about their preferences for medication use. They would prefer that these conversations began as early as possible so that their treating health professionals knew their preferences. General practitioners, pharmacists and nurses stated they often felt less comfortable discussing these issues as they were concerned that it may cause distress to the consumer. Health professionals and consumers alike thought that using the MATCH-D as a conversation starter could assist with these conversations.[7]
Research on the criteria
Translational research was undertaken with consumers, general practitioners, nurses and pharmacists to explore the enablers and barriers to using the MATCH-D in practice.[7] This research showed the need for a website (since launched at MATCH-D.com.au), checklists (available at the website) and educational resources.
The MATCH-D has been embedded into at least one electronic decision support app (the TAPER app). The National Health and Medical Research Council (NHMRC) are currently funding a randomised controlled trial implementing the MATCH-D using pharmacists embedded in general practice.[8]
Educational resources
The Dementia Training Australia is currently funding an interactive online education package for deprescribing in dementia centered around the MATCH-D. It is a joint collaboration between the University of Western Australia, University of Tasmania, LaTrobe University, Monash University, Alfred Health and FireFilms. This education package is anticipated to be launched in mid-2019. This online course will be suitable for consumers and health professionals, with a target audience of nurses working in residential aged care facilities. The training package will be in the format of a documentary film, with its original developer, Dr Page featured as narrator and interviewer. It will include simulated patient encounters and expert interviews, interspersed with interactive activities.
References
- "MATCH-D Medication Appropriateness Tool for Comorbid Health conditions during Dementia". www.match-d.com.au. Retrieved 2019-06-01.
- Page, A. T.; Potter, K.; Clifford, R.; McLachlan, A. J.; Etherton‐Beer, C. (2016). "Medication appropriateness tool for co-morbid health conditions in dementia: consensus recommendations from a multidisciplinary expert panel". Internal Medicine Journal. 46 (10): 1189–1197. doi:10.1111/imj.13215. ISSN 1445-5994. PMC 5129475. PMID 27527376.
- Etherton-Beer, Christopher; McLachlan, Andrew; Clifford, Rhonda; Potter, Kathleen; Page, Amy (2015-08-01). "Prescribing for Australians living with dementia: study protocol using the Delphi technique". BMJ Open. 5 (8): e008048. doi:10.1136/bmjopen-2015-008048. ISSN 2044-6055. PMC 4538244. PMID 26264272.
- Page, Amy; Etherton‐Beer, Christopher; Seubert, Liza J.; Clark, Vaughan; Hill, Xaysja; King, Stephanie; Clifford, Rhonda M. (2018). "Medication use to manage comorbidities for people with dementia: a systematic review". Journal of Pharmacy Practice and Research. 48 (4): 356–367. doi:10.1002/jppr.1403. ISSN 2055-2335.
- "Reducing the burden of multiple medicines for older dementia patients". Radio National. 2015-05-22. Retrieved 2019-06-01.
- "MATCH-D study gains consensus on dementia medicines management". AJP. 2016-08-17. Retrieved 2019-06-01.
- Etherton-Beer, Christopher D.; Parekh, Nikesh; Ryan, Cristin; Clark, Vaughan; King, Stephanie; Hill, Xaysja; McLachlan, Andrew J.; Seubert, Liza; Potter, Kathleen (2017-08-01). "Exploring the enablers and barriers to implementing the Medication Appropriateness Tool for Comorbid Health conditions during Dementia (MATCH-D) criteria in Australia: a qualitative study". BMJ Open. 7 (8): e017906. doi:10.1136/bmjopen-2017-017906. ISSN 2044-6055. PMC 5724063. PMID 28838905.
- http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377110