DIAMOND-Lewy Guidelines for Antipsychotic Use in Older Patients

NCT06357195 | Active Not Recruiting

• 1 other identifier: 2024H0075
• Study Type: observational
• Target: 1,000
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this observational study is to learn about current practices for the acute neuropsychiatric management of older adults during emergency department (ED) visits. Researchers will compare current standard of care practices with implemented guideline practice to see if standardized medication guidelines help reduce the usage of antipsychotics and/or benzodiazepines during acute presentations. The main questions this study aims to answer are:

• How many older adults are receiving antipsychotics or benzodiazepines during emergency department visits?
• Why are older adults receiving antipsychotics or benzodiazepines during emergency department visits?
• How many older adults who receive antipsychotics or benzodiazepines during emergency department visits have an underlying cognitive or movement disorder?
• What effects does administration of antipsychotics or benzodiazepines during emergency department visits have on patient outcomes in older adults and adults with neurocognitive disorders?
• Does implementation of standardized medication guidelines help reduce the usage of antipsychotics and/or benzodiazepines during acute presentations?

Conditions

Emergency Psychiatric; Cognition Disorder; Movement Disorders; Antipsychotics and Neuroleptics Toxicity; Dementia With Lewy Bodies; Alteration in Mental Status; Behavior; Aging

Outcome Measures

Primary Outcomes (2)

• Antipsychotic/Benzodiazepine

  Name of medication used

  From admission to discharge, up to 30 days

• Clinical Indication

  Reason for antipsychotic or benzodiazepine administration

  From admission to discharge, up to 30 days

Secondary Outcomes (3)

• Length of Stay

  From admission to discharge, up to 30 days

• Disposition

  From admission to discharge, up to 30 days

• Code Status

  From admission to discharge, up to 30 days

Eligibility Criteria

• Age: 54 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Older adults \>54 years old who receive antipsychotics or benzodiazepines in the ED and older adults \>54 years old who have underlying neurocognitive disorders and receive antipsychotics or benzodiazepines in the ED.

You may qualify if:

• Patients over the age of 54
• Received antipsychotic/benzodiazepine in the ED
• Have clinical signs or symptoms of underlying cognitive or movement disorders

You may not qualify if:

• None

Sponsors & Collaborators

• Ohio State University: lead

Study Sites (1)

The Ohio State University

Columbus, Ohio, 43210, United States

Location

Related Publications (6)

• Taylor JP, McKeith IG, Burn DJ, Boeve BF, Weintraub D, Bamford C, Allan LM, Thomas AJ, O'Brien JT. New evidence on the management of Lewy body dementia. Lancet Neurol. 2020 Feb;19(2):157-169. doi: 10.1016/S1474-4422(19)30153-X. Epub 2019 Sep 10.

  PMID: 31519472 BACKGROUND

• Weintraub D, Chen P, Ignacio RV, Mamikonyan E, Kales HC. Patterns and trends in antipsychotic prescribing for Parkinson disease psychosis. Arch Neurol. 2011 Jul;68(7):899-904. doi: 10.1001/archneurol.2011.139.

  PMID: 21747029 BACKGROUND

• Spears CC, Besharat A, Monari EH, Martinez-Ramirez D, Almeida L, Armstrong MJ. Causes and outcomes of hospitalization in Lewy body dementia: A retrospective cohort study. Parkinsonism Relat Disord. 2019 Jul;64:106-111. doi: 10.1016/j.parkreldis.2019.03.014. Epub 2019 Mar 23.

  PMID: 30930058 BACKGROUND

• Hill JD, Schmucker AM, Siman N, Goldfeld KS, Cuthel AM, Chodosh J, Bouillon-Minois JB, Grudzen CR. Emergency and post-emergency care of older adults with Alzheimer's disease/Alzheimer's disease related dementias. J Am Geriatr Soc. 2022 Sep;70(9):2582-2591. doi: 10.1111/jgs.17833. Epub 2022 May 25.

  PMID: 35612546 BACKGROUND

• Russek NS, Skappak C, Scheuermeyer F, Brousseau AA, McLeod SL, Melady D, Spencer M. Pharmacological Management of Agitation and Delirium in Older Adults: a Survey of Practices in Canadian Emergency Departments. Can Geriatr J. 2023 Sep 1;26(3):405-409. doi: 10.5770/cgj.26.666. eCollection 2023 Sep.

  PMID: 37662063 BACKGROUND

• McKeith IG, Boeve BF, Dickson DW, Halliday G, Taylor JP, Weintraub D, Aarsland D, Galvin J, Attems J, Ballard CG, Bayston A, Beach TG, Blanc F, Bohnen N, Bonanni L, Bras J, Brundin P, Burn D, Chen-Plotkin A, Duda JE, El-Agnaf O, Feldman H, Ferman TJ, Ffytche D, Fujishiro H, Galasko D, Goldman JG, Gomperts SN, Graff-Radford NR, Honig LS, Iranzo A, Kantarci K, Kaufer D, Kukull W, Lee VMY, Leverenz JB, Lewis S, Lippa C, Lunde A, Masellis M, Masliah E, McLean P, Mollenhauer B, Montine TJ, Moreno E, Mori E, Murray M, O'Brien JT, Orimo S, Postuma RB, Ramaswamy S, Ross OA, Salmon DP, Singleton A, Taylor A, Thomas A, Tiraboschi P, Toledo JB, Trojanowski JQ, Tsuang D, Walker Z, Yamada M, Kosaka K. Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology. 2017 Jul 4;89(1):88-100. doi: 10.1212/WNL.0000000000004058. Epub 2017 Jun 7.

  PMID: 28592453 BACKGROUND

Related Links

• DIAMOND-Lewy Management Toolkit

MeSH Terms

Conditions

Cognition Disorders; Movement Disorders; Lewy Body Disease; Behavior

Condition Hierarchy (Ancestors)

Neurocognitive Disorders; Mental Disorders; Central Nervous System Diseases; Nervous System Diseases; Parkinsonian Disorders; Basal Ganglia Diseases; Brain Diseases; Dementia; Synucleinopathies; Neurodegenerative Diseases

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor of Clinical Neurology and Psychiatry, Division Director of Cognitive Neurology

Study Record Dates

• First Submitted: April 4, 2024
• First Posted: April 10, 2024
• Study Start: July 1, 2024
• Primary Completion: January 1, 2026
• Study Completion (Estimated): July 1, 2026
• Last Updated: August 11, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)