Acute Hospital Care at Home for People Living With Dementia
Skipping the Hospital: Acute Hospital Care at Home for People Living With Dementia
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: David M Levine, MD, MPH, MA
- Phone Number: 617-732-7063
- Email: dmlevine@bwh.harvard.edu
Study Contact Backup
- Name: Fernando Chavarria, MD, MSc
- Phone Number: 857-307-2673
- Email: fchavarria@bwh.harvard.edu
Study Locations
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02120
- Brigham and Women's Hospital
-
Contact:
- David M Levine, MD, MPH, MA
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Diagnosis of moderate or severe dementia (as ascertained by the Quick Dementia Rating System; QDRS)
- Resides in a private or assisted living residence with or nearby (<15min travel time) to a family caregiver
- Resides within the Mass General Brigham (MGB) home hospital catchment area
- Has had at least 1 hospitalization in the last 12 months.
Exclusion Criteria:
- Hospitalized in the last 30 days
- No functioning utilities, such as no working heat (October-April), no running water, or no electricity.
- Resides in skilled nursing facility
- Resides in group home
- Domestic violence screen positive
- In police custody
- Family caregiver unable to initiate or maintain communication with care team
- End-stage renal disease on hemodialysis
- On methadone requiring daily pickup of medication
- Active substance use disorder, without functioning treatment plan
- Psychiatric diagnosis that would prohibit successful home hospital care
- Acute delirium without explanation or without the ability to manage at home
- Patients with cancer requiring consistent hospital-based treatments
- Cannot ambulate to bedside commode with assistance present in the home (if different from baseline), unless home-based aides are available
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Usual care
Acute care at a brick-and-mortar hospital.
|
Standard acute and emergency care delivered in a brick-and-mortar hospital setting.
|
|
Experimental: Acute hospital care at home
Home visit for a serious illness conversation.
Acute illness evaluation on demand.
Acute hospital care at home as needed.
|
Home visit for a serious illness conversation.
Acute illness evaluation on demand.
Acute hospital care at home as needed.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of days at home
Time Frame: Discharge to 30-days post discharge, up to 30 days
|
Sum of the number of days spent at home within the 30-days after an acute care episode
|
Discharge to 30-days post discharge, up to 30 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
30-day unplanned readmission or mortality
Time Frame: Discharge to 30-days post discharge, up to 30 days
|
Percentage of unplanned readmissions or mortality
|
Discharge to 30-days post discharge, up to 30 days
|
|
Delirium
Time Frame: Date of admission to date of discharge, estimated 5 days
|
Percentage of days experiencing delirium while receiving acute care using the short confusion assessment method.
|
Date of admission to date of discharge, estimated 5 days
|
|
Health-related quality of life
Time Frame: From enrollment for the period of one year
|
Absolute change of health-related quality of life over the year through the dementia quality of life survey (DEMQOL), or for patients unable to complete the survey, its proxy version (DEMQOL-Proxy).
|
From enrollment for the period of one year
|
|
Physical activity
Time Frame: Date of admission to date of discharge, estimated 5 days
|
Percent of time sedentary as measured by patch monitoring system.
|
Date of admission to date of discharge, estimated 5 days
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2025P000002
- R01AG082771-01A1 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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