Care Ecosystem: Navigating Patients and Families Through Stages of Care, Extension Trial

University of California San Francisco (UCSF)

Status

Completed

Conditions

Alzheimer Disease

Memory Disorders

Frontotemporal Lobar Degeneration

Dementia, Vascular

Dementia

Lewy Body Disease

Treatments

Behavioral: Navigated Care

Study type

Interventional

Funder types

Other

Other U.S. Federal agency

NIH

Identifiers

NCT04287738

1R01AG056715-01 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

This is an extension trial of a prior trial (NCT02213458). Both persons with dementia (PWD) and their caregivers were enrolled as dyads. The purpose of this randomized clinical trial is to evaluate the benefits of a program that supports model care for PWD and their caregivers. Whereas the prior trial only delivered care and examined outcomes up to 12-months, this trial extends care and outcome measurement for 5 years or until death, and includes all dyads where the caregiver reported high caregiver burden (Zarit-12 greater than or equal to 17) at pre-randomization baseline for the original trial. Participants were recruited from California, Nebraska and Iowa. Participants determined to be eligible were consented and randomized into one of two groups. Two thirds of dyads were enrolled into Navigated Care that provided them with phone-based assistance in meeting important benchmarks in their care, for example completion of legal and financial planning and strategies for minimizing caregiver burden. One third of dyads were enrolled to a control group, entitled Survey of Care. Outcomes were unchanged from the original trial except for the addition of time to long term care placement and are detailed below.

Enrollment

912 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

This study will enroll patients as well as their primary caregivers as research participants.

Inclusion criteria for patient participants:

Patient has a diagnosis of dementia with a progressive course
Patient has a primary caregiver (identified as having primary responsibility for patient) that is eligible for and agrees to join the study
Patient is covered by Medicare or Medi-caid or is Medi-pending
Patient is expected to live at least 3 months based on assessment by the referring provider, the patient's primary care provider, or medical record review
Patient speaks English, Cantonese, or Spanish
Patient lives in California or Nebraska or Iowa
Patient is age 45 or older

Inclusion criteria for caregiver participants:

Caregiver has primary responsibility for dementia patient that is eligible for and agrees to join the study
Caregiver speaks English, Cantonese, or Spanish
Caregiver is a legal adult
Zarit-12 caregiver burden score greater than or equal to 17 at pre-randomization (baseline); this criteria is specific to this extension trial

Exclusion Criteria:

Patient resides in a nursing home or skilled nursing facility at time of enrollment
Participant is enrolled in a similar clinical trial that precludes their participation in the investigator's trial
Patient is pregnant