Dementia in Long Term Care Facilities: Telemedicine for the Management of Neuropsychiatric Symptoms (DETECT)

Dementia in Long Term Care Facilities: Telemedicine for the Management of Neuropsychiatric Symptoms.

Telemedicine may facilitate adequate treatment of Neuropsychiatric symptoms (NPS) by identifying underlying causes and tailoring a treatment plan (pharmacological or non-pharmacologic treatments including provision of staff education and support, training in problem solving, and targeted therapy directed at the underlying causes for specific behaviors).

Study Overview

• Status: Completed
• Conditions: Dementia
• Intervention / Treatment: Procedure: telemedicine

Detailed Description

During a 6-months period, patients will be included in both arms, whenever they present a disruptive NPS that requires a specialist consultation based on the long-term care facility (LTCF) staff judgment. In the intervention group, a telemedicine (TM) consultation between the LTCF staff (medical and nurse staff) and the Memory Center from the University Hospital, will occur at inclusion (T0). Then, a second TM consultation will occur at 1 month (T1). In the control group management of NPS will be done as usual care. In both groups, patients' parameters such as non-programmed hospitalizations and/or consultations due to disruptive NPS, psychotropic drugs use, and health costs, will be evaluated at inclusion, 1 month and at 2 months. Acceptability of the TM among the LTCF staff will be assessed during the study in the intervention group.

The two university hospitals are composed of a group of institutions for elderly people located near Toulouse and Limoges.

• Study Type: Interventional
• Enrollment (Actual): 143
• Phase: Not Applicable

Contacts and Locations

Study Locations

• France
  • Limoges, France, 87042
    • UHLimoges
  • Toulouse, France, 31300
    • UHToulouse

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years and older (Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• patient aged 65 or more, with a dementia diagnosed by a specialist or the general practitioner;
• patient presenting with a disruptive NPS as defined in French Haute Autorité de Santé (HAS) recommendations (2009), that requires a specialist consultation based on the LTCF staff judgment;
• informed and written consent by the patient or the legal representative or the reliable person when appropriate;
• general practitioner agreement.

Exclusion Criteria:

• patient's life expectancy less than 6 months;
• Non agreement of study participation of patients or legal representative or the reliable person when appropriate.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: normal care; patients who will have normal care
Experimental: telemedicine; patients who will have telemedicine	Procedure: telemedicine; psycho-behavioural care by telemedicine

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Acceptability of the TM among the LTCF staff	Acceptability of the telemedicine (TM) among the LTCF staff which will be assessed in the intervention group by quantitative indicators (proportion of the solicitation of the TM solution among patients with disruptive NPS, the delay to obtain a TM consultation and the number of the staff participants at each TM consultation) and qualitative indicators (staff global satisfaction will be evaluated by focus groups and interviewing).	6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rate of non-programmed hospitalizations and/or consultation due to disruptive NPS	Calculation of the rate of non-programmed hospitalizations and/or consultation due to disruptive NPS in both groups	6 months
The psychotropic drugs used	Description of psychotropic drugs used in both groups	6 months
describe the health costs	Description of the health costs in both groups	6 months
describe the estimation of the cluster effect ("design effect")	Estimation of the cluster effect ("design effect") in both groups	6 months

Collaborators and Investigators

• Sponsor: University Hospital, Toulouse
• Investigators: Principal Investigator: Maria Soto, MD, University Hospital, Toulouse

Publications and helpful links

General Publications

• Piau A, Nourhashemi F, De Mauleon A, Tchalla A, Vautier C, Vellas B, Duboue M, Costa N, Rumeau P, Lepage B, Soto Martin M. Telemedicine for the management of neuropsychiatric symptoms in long-term care facilities: the DETECT study, methods of a cluster randomised controlled trial to assess feasibility. BMJ Open. 2018 Jun 12;8(6):e020982. doi: 10.1136/bmjopen-2017-020982.
• Piau A, Vautier C, De Mauleon A, Tchalla A, Rumeau P, Nourhashemi F, Soto-Martin M. Health workers perception on telemedicine in management of neuropsychiatric symptoms in long-term care facilities: Two years follow-up. Geriatr Nurs. 2020 Nov-Dec;41(6):1000-1005. doi: 10.1016/j.gerinurse.2020.07.009. Epub 2020 Aug 6.

Study record dates

Study Major Dates

• Study Start: June 1, 2015
• Primary Completion (Actual): November 1, 2017
• Study Completion (Actual): November 1, 2017

Study Registration Dates

• First Submitted: June 1, 2015
• First Submitted That Met QC Criteria: June 10, 2015
• First Posted (Estimated): June 15, 2015

Study Record Updates

• Last Update Posted (Actual): June 1, 2023
• Last Update Submitted That Met QC Criteria: May 31, 2023
• Last Verified: May 1, 2023

More Information

Terms related to this study

• Keywords: dementia; neuropsychiatric symptoms; telemedicine; long-term care facilities
• Additional Relevant MeSH Terms: Mental Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurocognitive Disorders; Dementia
• Other Study ID Numbers: 13 7031 08