Piloting the IPROACTIF Program to Preserve Functioning and Prevent Cognitive Decline

University of Illinois

Status: Completed

Conditions: Uncontrolled Diabetes (HBA1c ≥ 10); Heart Disease (Coronary Artery Disease, Ischemic Heart Disease, Hypertensive Heart Disease)

Treatments: Other: IPROACTIF (Integrated PRimary Care and Occupational Therapy for Aging and Chronic Disease Treatment to preserve Independence and Functioning); Other: Usual primary care services

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT04682977

5P30AG022849-17 (U.S. NIH Grant/Contract)

2020-1461

Details and patient eligibility

About

Conduct a pilot randomized control to assess the preliminary efficacy of IPROACTIF, an occupational therapist-delivered primary care intervention for aging and chronic disease management.

Full description

The IPROACTIF intervention is based on the premise of preventing the physical and cognitive decline that is associated with aging and chronic disease. The 12-week intervention includes a comprehensive assessment of ADL functioning and ten intervention sessions addressing disease management, physical activity and executive functioning. This pilot randomized control trial will compare whether patients who receive IPROACTIF perform better than usual care patients on physical functioning, self-efficacy for chronic disease management, physical activity levels, executive functioning, health-related quality of life, and participation in life roles and activities.

Enrollment: 45 patients

Sex: All

Ages: 55+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

• English speaking
• Community-dwelling
• 55 years of age
• Primary diagnosis of heart disease (coronary artery disease, ischemic heart disease, hypertensive heart disease), or uncontrolled diabetes (HBA1c greater than/equal to 10)
• Self-reported risk of functional decline (score of 3 or higher) on the 11-item Brief Risk Identification of Geriatric Health Tool or self-reported need for assistance with disease management

Exclusion Criteria

• Current/past diagnosis of stroke or other neurological disorders
• Receiving pharmacological treatment for cognition
• Participating in other exercise or ADL-focused intervention studies
• Non-English speaking
• Residing in a long-term care institution
• Compromised decision-making capacity (score >8 on SOMCT)

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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45 participants in 2 patient groups

IPROACTIF

Experimental group

Description:

10 weekly sessions. First two sessions focus on comprehensive assessment of physical and executive functioning, assessment of home safety and accessibility, assessment of ADL/IADL competence and performance in context; information in these areas is used by the interventionist to collaboratively identify three patient-centered goals. Goal planning is followed by 10 treatment sessions. Treatment sessions focus on chronic disease education, problem solving issues related to disease management by modifying daily routines, recommendations for embedding physical activity in everyday tasks, and environmental modifications or activity adaptations to increase ADL/IADL independence.

Treatment:

Other: IPROACTIF (Integrated PRimary Care and Occupational Therapy for Aging and Chronic Disease Treatment to preserve Independence and Functioning)

Usual care

Other group

Description:

Participants in the control group will receive usual services which might include primary care and prescription medications for chronic disease management.

Treatment:

Other: Usual primary care services