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Noll Campbell, PharmD, MS
Assistant Professor, Purdue University
Faculty Associate, CALC, Purdue University
Scientist, IU Center for Aging Research
Scientist, IU Center for Innovation & Implementation Science
Clinical Pharmacy Specialist, Eskenazi Health
campbenl@iupui.edu
Artificial Intelligence and Disabilities:
Cognitive Impairment & Dementia
eCHAMP Study Justification
• Improving the care of hospitalized older adults
with acute or chronic cognitive impairment
eCHAMP
Khan, et al. JAGS 2011
Identify
presence
of CI
ACh ↓
Referral to
Geriatrics
Primitive AI:
Provider-Focused CDS Notification
Baseline variable
CDSS
N = 199
Usual Care
N = 225 P Value
Mean Age (SD) 76.8 (7.9) 77.6 (8.3) 0.32
% Female 60.3% 71.1% 0.02
% African American 61.8% 57.3% 0.37
Mean CCI (SD) 1.8 (1.8) 2.4 (2.1) <0.001
Mean SPMSQ (SD) 5.2 (2.6) 5.1(2.8) 0.67
% Delirium at Screening 30.2% 31.1% 0.83
eCHAMP Results
CDSS
N = 199
Usual Care
N = 225
P value
adjusted*
Percent with any ACB order
- First 48 hours of hospital stay
- Entire hospitalization
13.6%
23.6%
14.7%
21.3%
0.91
0.33
Percent of ACB orders discontinued$
- First 48 hours of hospitalization
- Entire hospitalization
7.4%
48.9%
3.0%
31.2%
0.46
0.11
Percent with any ACB discontinuation order
- First 48 hours of hospital stay
- Entire hospitalization
1.0
11.6%
0.4
6.7%
0.41
0.05
*Adjusted for Age, Gender, Race, SPMSQ, and Charlson comorbidity
$ Denominator was number of orders eligible for discontinuation
Boustani M, et al. J Gen Intern Med 2012 May;27(5):561-7
PMD Study Justification
• Pharmacologic Management of Delirium to
reduce short and long-term complications
PMD
Low dose
haloperidol
ACh ↓
BZD ↓
Khan, et al. JAGS 2011
Pre-Randomization Post-Randomization
PMDa
(N=170)
Usual Care
(N=176)
P-value PMD
(N=170)
Usual Care
(N=176)
P-value
Haloperidol
Exposedb n (%) 29 (17.1) 32 (18.2) 0.888 116 (68.2) 56 (31.8) <0.001
Median daily
Dose (IQR)
0 (0-0) 0 (0-0) 0.723 0.5 (0-0.9) 0 (0-0.3) <0.001
Benzodiazepinesc
Exposedb n (%) 122 (71.8) 118 (67.0) 0.353 97 (57.1) 116 (65.9) 0.098
Median daily
Dose (IQR)
1.3 (0 –
13.1)
1.0 (0-10.5) 0.466 0.1 (0-2.0) 0.3 (0-3.2) 0.079
Anticholinergic
Burdend
Exposedb n (%) 30 (17.6) 29 (16.5) 0.777 44 (25.9) 54 (30.7) 0.342
Median daily
score (IQR)
0 (0-0) 0 (0-0) 0.706 0 (0-0.1) 0 (0-0.2) 0.248
Campbell NL, et al. J Am Geriatr Soc 2019 Apr;67(4):695-702
Khan BA, et al. J Am Geriatr Soc 2019 May;67(5):1057-1065
Brain Safety Lab
R2D2
Funding: NIA
R01AG061452
PI: Noll Campbell
Cluster-randomized trial
to determine whether
deprescribing
anticholinergics
improves clinical
outcomes in older adults
Brain Safe
Funding: NIA
R01AG056926
PI: Rich Holden
Randomized trial to
determine if a mobile,
scalable deprescribing
intervention reduces use of
anticholinergics among
older adults
PSLL
Funding: AHRQ
P30HS24384
PI: Chris Callahan
Randomized trial of a
system-wide dual
provider and patient-
focused deprescribing
intervention in primary
care
Noll Campbell, PharmD, MS
Assistant Professor, Purdue University
Faculty Associate, CALC, Purdue University
Scientist, IU Center for Aging Research
Scientist, IU Center for Innovation & Implementation Science
Clinical Pharmacy Specialist, Eskenazi Health
campbenl@iupui.edu
Artificial Intelligence and Disabilities:
Cognitive Impairment & Dementia

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Noll Campbell,"Artificial Intelligence & Disabilities: Cognitive Impairment and Dementia"

  • 1. Noll Campbell, PharmD, MS Assistant Professor, Purdue University Faculty Associate, CALC, Purdue University Scientist, IU Center for Aging Research Scientist, IU Center for Innovation & Implementation Science Clinical Pharmacy Specialist, Eskenazi Health campbenl@iupui.edu Artificial Intelligence and Disabilities: Cognitive Impairment & Dementia
  • 2. eCHAMP Study Justification • Improving the care of hospitalized older adults with acute or chronic cognitive impairment eCHAMP Khan, et al. JAGS 2011 Identify presence of CI ACh ↓ Referral to Geriatrics
  • 3. Primitive AI: Provider-Focused CDS Notification Baseline variable CDSS N = 199 Usual Care N = 225 P Value Mean Age (SD) 76.8 (7.9) 77.6 (8.3) 0.32 % Female 60.3% 71.1% 0.02 % African American 61.8% 57.3% 0.37 Mean CCI (SD) 1.8 (1.8) 2.4 (2.1) <0.001 Mean SPMSQ (SD) 5.2 (2.6) 5.1(2.8) 0.67 % Delirium at Screening 30.2% 31.1% 0.83
  • 4. eCHAMP Results CDSS N = 199 Usual Care N = 225 P value adjusted* Percent with any ACB order - First 48 hours of hospital stay - Entire hospitalization 13.6% 23.6% 14.7% 21.3% 0.91 0.33 Percent of ACB orders discontinued$ - First 48 hours of hospitalization - Entire hospitalization 7.4% 48.9% 3.0% 31.2% 0.46 0.11 Percent with any ACB discontinuation order - First 48 hours of hospital stay - Entire hospitalization 1.0 11.6% 0.4 6.7% 0.41 0.05 *Adjusted for Age, Gender, Race, SPMSQ, and Charlson comorbidity $ Denominator was number of orders eligible for discontinuation Boustani M, et al. J Gen Intern Med 2012 May;27(5):561-7
  • 5. PMD Study Justification • Pharmacologic Management of Delirium to reduce short and long-term complications PMD Low dose haloperidol ACh ↓ BZD ↓ Khan, et al. JAGS 2011
  • 6. Pre-Randomization Post-Randomization PMDa (N=170) Usual Care (N=176) P-value PMD (N=170) Usual Care (N=176) P-value Haloperidol Exposedb n (%) 29 (17.1) 32 (18.2) 0.888 116 (68.2) 56 (31.8) <0.001 Median daily Dose (IQR) 0 (0-0) 0 (0-0) 0.723 0.5 (0-0.9) 0 (0-0.3) <0.001 Benzodiazepinesc Exposedb n (%) 122 (71.8) 118 (67.0) 0.353 97 (57.1) 116 (65.9) 0.098 Median daily Dose (IQR) 1.3 (0 – 13.1) 1.0 (0-10.5) 0.466 0.1 (0-2.0) 0.3 (0-3.2) 0.079 Anticholinergic Burdend Exposedb n (%) 30 (17.6) 29 (16.5) 0.777 44 (25.9) 54 (30.7) 0.342 Median daily score (IQR) 0 (0-0) 0 (0-0) 0.706 0 (0-0.1) 0 (0-0.2) 0.248 Campbell NL, et al. J Am Geriatr Soc 2019 Apr;67(4):695-702 Khan BA, et al. J Am Geriatr Soc 2019 May;67(5):1057-1065
  • 7.
  • 8. Brain Safety Lab R2D2 Funding: NIA R01AG061452 PI: Noll Campbell Cluster-randomized trial to determine whether deprescribing anticholinergics improves clinical outcomes in older adults Brain Safe Funding: NIA R01AG056926 PI: Rich Holden Randomized trial to determine if a mobile, scalable deprescribing intervention reduces use of anticholinergics among older adults PSLL Funding: AHRQ P30HS24384 PI: Chris Callahan Randomized trial of a system-wide dual provider and patient- focused deprescribing intervention in primary care
  • 9. Noll Campbell, PharmD, MS Assistant Professor, Purdue University Faculty Associate, CALC, Purdue University Scientist, IU Center for Aging Research Scientist, IU Center for Innovation & Implementation Science Clinical Pharmacy Specialist, Eskenazi Health campbenl@iupui.edu Artificial Intelligence and Disabilities: Cognitive Impairment & Dementia