Jinjiao Wang Receives $1.2 Million from NIH to Study Antipsychotic Deprescribing in Hospital-to-Home Healthcare Transitions

Adults with Alzheimer’s disease and related dementias who take antipsychotics face wide-ranging health risks, yet these medications remain commonly used, especially during transitions of care such as hospital-to-home.

Associate Professor Jinjiao Wang, PhD, RN, has received the National Institutes on Aging’s Paul B. Beeson Emerging Leaders Career Development Award (K76) to support a study on deprescribing, or the supervised process of optimizing and/or reducing the use of medications that are potentially harmful or no longer beneficial, among post-acute care older adults with dementia in home health care.

“This award will enable me to develop and implement an intervention that is important to the well-being and safety of patients and caregivers, and build it into a form that could potentially be scalable nationwide through collaboration with the home care industry,” Wang said.

While a majority of adults with dementia are community-dwelling, most research on medication management and deprescribing for this population has focused on institutions such as hospitals and nursing homes.

Previous research by Wang and colleagues at the University of Rochester Medical Center found that antipsychotic medications are potentially over-prescribed and used inappropriately among home healthcare patients to address behavioral and psychological symptoms of dementia.

Transitions of care can be a high-risk time period for an already vulnerable population, but it also brings high reward, as the change of settings from hospital to home also sets up an ideal situation for deprescribing to take place. There’s an existing model of care to support this process, Medicare covers it, and the home healthcare workforce has the right training to make it achievable.

“Members of the home healthcare workforce, especially nurses and therapists, are trained in symptom monitoring and management, patient education, caregiver support, and conducting home medication reviews, all of which are necessary pieces for deprescribing to take place,” Wang explained.

Wang, a registered nurse with experience in home healthcare, is one of just a few nurses to receive the Beeson Award in its history — a milestone that she considers a reminder of nurses’ significance in aging research and ensuring older adults’ well-being.

“Our work has become more visible to the broader community of aging researchers, thanks to giants in the field of geriatric nursing who opened doors for us," she said.

Wang also shared gratitude for her colleagues in the School of Nursing’s Research mission, especially Dean Lisa Kitko, PhD, RN, FAHA, FAAN, Associate Dean for Research Sally Norton, PhD, RN, FNAP, FPCN, FAAN, her primary co-mentor, Professor Kathi Heffner, PhD, as well as Yeates Conwell, MD, professor of psychiatry at URMC.

Additional mentors and collaborators include Thomas Caprio, MD, professor of geriatrics & aging and a member of the School of Nursing's clinical faculty; Anton Porsteinsson, MD, professor of psychiatry, neurology, neuroscience, and medicine; and Yue Li, PhD, professor of public health, as well as the Greater Rochester Practice-Based Research Network (GR-PBRN).

This award is also supported by scientists, clinicians and organizations beyond Rochester, including Kobi Nathan, PharmD (St. John Fisher University), Sandra Simmons, PhD, and Amanda Mixon, MD (Vanderbilt University); Andrea Devoti (National Association for Home Care & Hospice), Cynthia Boyd, MD (Johns Hopkins University), as well as Michael Steinman, MD (UC San Francisco) from the NIA-funded U.S. Deprescribing Research Network.

Read more about Wang and the School of Nursing's Elaine C. Hubbard Center for Nursing Research on Aging. Get the latest UR Nursing news in your inbox.