Connect-Home: Alzheimer's Disease and Related Dementias (CH-ADRD)
Transitional Care for Skilled Nursing Facility Patients With Alzheimer's Disease and Related Dementias and Their Caregivers: a Cluster Randomized Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Connect-Home ADRD is a Donabedian-guided intervention that introduces new structure and processes to support Skilled Nursing Facility (SNF) staff delivery of transitional care for transitions to home, assisted living, or long-term care, and post-discharge transitional care by the Dementia Caregiving Specialist (DCS).
The research objective is to test the efficacy of Connect-Home ADRD, a transitional care intervention, targeting Skilled Nursing Facility (SNF) patients with Alzheimer's disease and related dementias (ADRD) and their primary caregivers who discharge home and other settings of care. The study will be set in 12 North Carolina SNFs and in the patient's discharge destination (during intervention periods only). Using a cluster-randomized trial design, twelve SNFs will be randomly allocated to an intervention group (N=6 SNFs) and to a control group (N=6 SNFs) by a study statistician masked to SNF identity. 360 dyads of SNF patients with ADRD and caregivers will be enrolled in 12 SNFs.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Molly Lynch, MS
- Phone Number: 9198438874
- Email: molly_lynch@unc.edu
Study Contact Backup
- Name: Kathryn Wessell, MPH
- Phone Number: 919-966-2939
- Email: kwessell@email.unc.edu
Study Locations
-
-
North Carolina
-
Chapel Hill, North Carolina, United States, 27599
- Recruiting
- University of North Carolina at Chapel Hill
-
Contact:
- Molly Lynch, MS
- Phone Number: 919-843-8874
- Email: molly_lynch@unc.edu
-
Contact:
- Mark Toles, PhD, RN
- Phone Number: 9199665684
- Email: mtoles@email.unc.edu
-
Sub-Investigator:
- Laura Hanson, MD
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Patients:
- Ability to speak English
- Goal of discharge to home, assisted living, or long-term care
- Diagnosis of dementia
- Having a caregiver willing to participate
Caregivers:
- Ability to speak English
- Legally authorized representative (LAR) who also provides support for the person with ADRD
Inclusion criteria for SNFs:
- Location within 120 miles of UNC-Chapel Hill
- Admission of at least 75 SNF patients per year
Exclusion Criteria:
Patients:
- Planned hospital readmission for procedures or treatments within 30 days post enrollment.
Caregivers:
- LAR is a court-appointed guardian.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Connect-Home ADRD Intervention
The Connect-Home ADRD Intervention will include:
|
Connect-Home ADRD will introduce new structure and processes to support SNF staff delivery of transitional care for transitions to home, assisted living, or long-term care, and post-discharge transitional care by the Dementia Caregiving Specialist.
|
|
No Intervention: Standard Care - Control Group
Patient and caregiver dyad randomized to the control arm will receive usual SNF and post-discharge care.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Caregiver Strain
Time Frame: 30 days after discharge from SNF
|
Modified Caregiver Strain Index Score (MCSI): 13 yes-no items, measure indicators of caregiver strain over the past 30 days.
Summary score ranges from 0-26, higher scores indicating greater strain.
|
30 days after discharge from SNF
|
|
Patient Neuropsychiatric Symptoms
Time Frame: 30 days after discharge from SNF
|
Neuropsychiatric Inventory-Q (NPI-Q): 12 items on a 3-point scale, measures presence and severity of neuropsychiatric symptoms over the past 30 days.
Summary score ranges from 0-36, higher scores associated with more severe symptoms.
|
30 days after discharge from SNF
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Caregiver Depression
Time Frame: 30 days after discharge from SNF
|
Patient Health Questionnaire-8 (PHQ-8): 9 items on a 4-point scale, measures depressive symptoms over the past 30 days.
Scores range from 0-27, higher scores indicate more depressive symptoms.
|
30 days after discharge from SNF
|
|
Preparedness for care transitions
Time Frame: 30 days after discharge from SNF
|
Care Transitions Measure-15 (CTM-15): 15 items on a 4-point scale, measures self-reported knowledge to continue care after discharge.
Summary score ranges from 0-100, higher scores associated with less acute care use after discharge.
|
30 days after discharge from SNF
|
|
Patient Quality of Life
Time Frame: 30 days after discharge from SNF
|
Quality of Life in Alzheimer's Disease (QoL-AD): 13 items on a 4-point scale measuring caregiver-reported quality of life in people with ADRD over the past 30 days.
Summary scores range from 13-52, with higher scores indicating higher quality of life.
|
30 days after discharge from SNF
|
|
Acute Care Use
Time Frame: 30 days after discharge from SNF
|
Caregiver-reported days of emergency department and hospital use in 30 days after SNF discharge.
|
30 days after discharge from SNF
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Mark Toles, PhD, RN, University of North Carolina, Chapel Hill
Study record dates
Study Major Dates
Study Start (Actual)
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
- 24-2766
- 2R01NR017636-05A1 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
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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