NRC:Improving Healthcare for Cognitively Impaired Elders and Their Caregivers

Alzheimer Disease Clinical Trial

— RDAD&APNs  

Official title:

NRC: Improving Healthcare for Cognitively Impaired Elders and Their Caregivers

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT03289377
• Other study ID #: STUDY00003731
• Status: Recruiting
• Phase: N/A
• Start date: February 1, 2018
• Est. completion date: October 2018

Study information

• Verified date: May 2018
• Source: University of Washington
• Contact: Christine A Coulter, Ph.D.
• Phone: 206-685-9169
• Email: cac76[@]uw.edu
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

An multi-stage mixed-method design will be employed to obtain both qualitative and quantitative data to address two study aims: (1) Evaluate and refine the delivery Reducing Disabilities in Alzheimer's Disease (RD- AD) training to advanced practice nurses and (2) Evaluate and refine the implementation of RD-AD by advanced practice nurses in their medical settings.

Description:

Two waves of APNs (25 each wave/total 50) will receive RDAD training and be queried pre and post- training using both qualitative and quantitative procedures to determine: (1) Is RDAD training successfully received by advanced practice nurses? (2) Do they report it as relevant to improving the care they deliver to persons with Alzheimer's Disease and Related Dementias (ADRD)? (3) Does RDAD training of advanced practice nurses improve their level of knowledge about ADRD, their skills in providing ADRD care, and their level of confidence in providing this care?

A subset of advanced practice nurses (5 per wave, total of 10) will be recruited to implement RDAD as part of their ongoing care of persons with ADRD.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 50
• Est. completion date: October 2018
• Est. primary completion date: October 2018
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• Licensed by the Washington state Department of Health as an Advanced Registered Nurse Practitioner (ARNP),

• Hold a board certification as a Gerontological Nurse Practitioner, Adult Nurse Practitioner, or Family Nurse Practitioner,

• Work at least half time (0.50 FTE) in a clinical setting (primary care, internal medicine, sub-specialty, medical home), with a panel consisting of over 25% of patients over 65 years of age,

• Have no expectation for termination over the course of the study; and

• Agree to participate in all phases of the RDAD translational program.

Exclusion Criteria:

Related Conditions & MeSH terms

• Alzheimer Disease
• Nurse Training

Intervention

Behavioral:
• RDAD Training
An interactive processes of lecture, role-play, and discussion, APNs will have the opportunity to dissect all phases of RDAD to insure they understand the objectives, can enact the program, and feel confident they can problem-solve situations that arise. APNs will receive materials to insure they are knowledgeable about ADRD symptoms, behavior management techniques, and exercise safety.

Locations

Country	Name	City	State
United States	University of Washington	Seattle	Washington

Sponsors (1)

Lead Sponsor	Collaborator
University of Washington

Country where clinical trial is conducted

United States, 

References & Publications (9)

Brodaty H, Arasaratnam C. Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. Am J Psychiatry. 2012 Sep;169(9):946-53. doi: 10.1176/appi.ajp.2012.11101529. Erratum in: Am J Psychiatry. 2013 Feb 1;170(2):227. — View Citation

Bruce DG, Paley GA, Nichols P, Roberts D, Underwood PJ, Schaper F. Physical disability contributes to caregiver stress in dementia caregivers. J Gerontol A Biol Sci Med Sci. 2005 Mar;60(3):345-9. — View Citation

Gaugler JE, Duval S, Anderson KA, Kane RL. Predicting nursing home admission in the U.S: a meta-analysis. BMC Geriatr. 2007 Jun 19;7:13. Review. — View Citation

Koch T, Iliffe S; Evidem Programme. The role of primary care in the recognition of and response to dementia. J Nutr Health Aging. 2010 Feb;14(2):107-9. — View Citation

Kukull WA, Higdon R, Bowen JD, McCormick WC, Teri L, Schellenberg GD, van Belle G, Jolley L, Larson EB. Dementia and Alzheimer disease incidence: a prospective cohort study. Arch Neurol. 2002 Nov;59(11):1737-46. — View Citation

Mohamed S, Rosenheck R, Lyketsos CG, Schneider LS. Caregiver burden in Alzheimer disease: cross-sectional and longitudinal patient correlates. Am J Geriatr Psychiatry. 2010 Oct;18(10):917-27. doi: 10.1097/JGP.0b013e3181d5745d. — View Citation

Small GW, Rabins PV, Barry PP, Buckholtz NS, DeKosky ST, Ferris SH, Finkel SI, Gwyther LP, Khachaturian ZS, Lebowitz BD, McRae TD, Morris JC, Oakley F, Schneider LS, Streim JE, Sunderland T, Teri LA, Tune LE. Diagnosis and treatment of Alzheimer disease and related disorders. Consensus statement of the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society. JAMA. 1997 Oct 22-29;278(16):1363-71. Review. — View Citation

Teri L, Gibbons LE, McCurry SM, Logsdon RG, Buchner DM, Barlow WE, Kukull WA, LaCroix AZ, McCormick W, Larson EB. Exercise plus behavioral management in patients with Alzheimer disease: a randomized controlled trial. JAMA. 2003 Oct 15;290(15):2015-22. — View Citation

Tun SM, Murman DL, Colenda CC. Concurrent validity of neuropsychiatric subgroups on caregiver burden in Alzheimer disease patients. Am J Geriatr Psychiatry. 2008 Jul;16(7):594-602. doi: 10.1097/JGP.0b013e318173f5fc. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Physician Confidence in Dementia Care Skills	A 12-item self-report measure (administered to ARNPs) designed to measure perception of ability to address the care needs of patients with ADRD.	Change from baseline score at 2 months
Primary	Sense of Competence in Dementia	A 17-item questionnaire covering 4 domains: job satisfaction, attitude towards dementia, work experience, and level of dementia knowledge.	Change from baseline score at 2 months
Primary	Dementia Attitudes Scale	A 20-item scale to measures attitudes towards dementia with a two-factor structure; "dementia knowledge" and "social comfort".	Change from baseline score at 2 months
Secondary	Focus Group Questions	Questions to determine satisfaction with a acceptability of RDAD	At 2 months
Secondary	Implementation Questions	Questions to determine Acceptability of RDAD	At 2 months

External Links

•   Dementia and its implications for public health 2006
•   Medicare data claims data Baltimore, MD