Indiase zorgtraining voor transformatie van Alzheimer (INTACT) (INTACT)
INTACT will utilize a group-randomized trial, to test the effectiveness of a culturally informed provider training and "dementia friendly clinic" intervention for detection and appropriate management of AI/AN patients with ADRD and MCI in 28 urban and rural clinics serving AI/ANs.
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Gedetailleerde beschrijving
The INTACT team will conduct a group-randomized trial (GRT) to test the effectiveness of the INTACT program, a culturally informed primary care provider training and clinic level workflow intervention for detection and appropriate management of AI/AN patients with Mild Cognitive Impairment (MCI) and ADRD in 28 urban and rural clinics serving AI/ANs. The clinics are the primary unit of randomization. Within each participating clinic, PCPs who are routinely seeing AI/AN patients ages 55 years and older will be recruited for data collection at baseline and 1-year follow-up. Each clinic will be randomized either to the immediate intervention or to a wait-list control arm. Data will be collected from PCP questionnaires, Electronic Health Records (EHR) data extraction and manual medical chart reviews. At the clinic level, we will rely on EHRs to document INTACT's effect on new ADRD diagnoses. At the PCP level, we will test whether INTACT increases knowledge and confidence in dementia assessment, ADRD care, and caregiver support. Patient-level data will be collected from the EHR and by manual chart review.
Once enrolled, clinics will complete a clinic profile interview and clinic and patient population information form, PCPs will be consented and complete a baseline survey. Next the clinics will be randomized into the immediate intervention or the wait-list control arms. Data collection will be conducted at baseline and 1-year follow-up. After completing the 1-year study period, clinics in the wait-list arm will have the opportunity to receive the INTACT intervention.
Studietype
Studietype
Inschrijving (Werkelijk)
Inschrijving
Fase
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
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Washington
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Seattle, Washington, Verenigde Staten, 98101
- Washington State University
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Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
CLINIC Eligibility criteria
To be eligible to participate in INTACT a clinic must be:
- A primary care clinic
- Have at least 20 AI/AN active patients 55 years or older
- Have an EHR system
- Not intending to change EHR systems in the next year
- Willing to conduct a total of 40 limited patient chart reviews to assess quality of care metrics for AI/AN patients with MCI and ADRD, staff permitting
PCP
Eligibility criteria:
To be eligible to participate in the baseline and follow-up surveys a primary care provider must be:
- have a title of MD, DO, Nurse Practitioner, or PA, and
- regularly provides care to AI/ANs aged 65 and older.
PATIENTS
We will only collect patient EHR data from eligible patients who:
- Recorded as AI/AN in the EHR system
- Active clinic patient with prevalent ADRD as of the first day of the time period each data extraction will cover
- Age 55 or older at the start of the surveillance interval
- At least one primary care clinic visit during the time period each data extraction will cover.
There are no exclusion criteria for the clinic, PCPs and patients.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Onderzoek naar gezondheidsdiensten
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Aantal wapens
Wapens en interventies
Deelnemersgroep / ArmDeelnemersgroep / Arm |
Interventie / BehandelingInterventie / Behandeling |
|---|---|
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Experimenteel: Intervention
The INTACT Program has three components:
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The INTACT Program has three components:
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Ander: Waitlist
The INTACT Program has three components:
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The INTACT Program has three components:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Clinic Level - new diagnoses of ADRD and MCI (Aim 2)
Tijdsspanne: Baseline and 12-month follow-up
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Primary outcome (as obtained directly from EHRs) will reflect the aggregate counts of new diagnoses (MCI, ADRD, other dementia) during the study period, based on the ICD-10 codes for these diagnoses. |
Baseline and 12-month follow-up
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PCP level - care confidence (Aim 1)
Tijdsspanne: Baseline and a 12-month follow-up
|
Within each clinic, each participating PCP will complete a baseline and a 12-month follow-up survey. The PCP level primary outcome is care confidence in providing dementia care to patients and their families. Care confience wil be measured using the General Practitioners Confidence and Attitude scale for Dementia (GPACS-D) whic uses a 5 point Likert scale from 1 (strongly agree) to 5 (strongly disagree). The GPACS-D scale has 3 subscales:
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Baseline and a 12-month follow-up
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Patient level - quality of care 1 (Aim 3)
Tijdsspanne: Baseline and a 12-month follow-up
|
Primary outcome (as obtained directly from EHRs) will reflect the number and type of ADRD diagnostic tests. |
Baseline and a 12-month follow-up
|
|
Patient level - quality of care 2 (Aim 3)
Tijdsspanne: Baseline and a 12-month follow-up
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Primary outcome (as obtained directly from EHRs) will reflect the number of prescriptions of appropriate medications for cognitive and mood symptoms. |
Baseline and a 12-month follow-up
|
|
Patient level - quality of care 3 (Aim 3)
Tijdsspanne: Baseline and a 12-month follow-up
|
Primary outcome (as obtained directly from EHRs) will reflect the number of annual cognitive assessments. |
Baseline and a 12-month follow-up
|
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Patient level - quality of care 4 (Aim 3)
Tijdsspanne: Baseline and a 12-month follow-up
|
Primary outcome (as obtained directly from EHRs) will reflect the number advance care directive. |
Baseline and a 12-month follow-up
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Patient level - quality of care 5 (Aim 3)
Tijdsspanne: Baseline and a 12-month follow-up
|
Primary outcome (as obtained directly from EHRs) will reflect the number of annual evauations of functional status. |
Baseline and a 12-month follow-up
|
|
Patient level - quality of care 5 (Aim 3)
Tijdsspanne: Baseline and a 12-month follow-up
|
Primary outcome (as obtained directly from EHRs) will reflect the number of pharmacoligical treatment changes. |
Baseline and a 12-month follow-up
|
Medewerkers en onderzoekers
Sponsor
Sponsor
Medewerkers
Medewerkers
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Studie start
Primaire voltooiing (Werkelijk)
Primaire voltooiing
Studie voltooiing (Werkelijk)
Studie voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update geplaatst
Laatste update ingediend die voldeed aan QC-criteria
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
Andere studie-ID-nummers
- 19630
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
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