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 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. 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] Respected organisations such as the New South Wales' Therapeutic Advisory Group (TAG) highlighted the importance of the work in their newsletters.

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]

It is cited and promoted by influential national international bodies including:

- the British Geriatrics Society's End of Life Care in Frailty guidelines^[8]

- Australia's RACGP aged care clincial guide known as the Silver Book^[9]

- New Zealand's Health Quality & Safety Commission's medication management work ^[10]

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 ), 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.^[11]

Educational resources[]

The Dementia Training Australia funding an interactive online education package for deprescribing in dementia centered around the MATCH-D. It was a joint collaboration between the University of Western Australia, University of Tasmania, LaTrobe University, Monash University, Alfred Health and FireFilms. This education package launched in mid-2019.^[12] This online course is suitable for consumers and health professionals, with a target audience of nurses working in residential aged care facilities. The training package was in the format of a documentary film, with its original developer, Dr Page featured as narrator and interviewer. It includes simulated patient encounters and expert interviews, interspersed with interactive activities.

References[]