Pathway to Detection & Differentiation of Delirium & Dementia in the Emergency Department

Dementia Clinical Trial

— IMPACT  

Official title:

Pathway to Detection & Differentiation of Delirium & Dementia in the Emergency Department

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04846322
• Other study ID #: 2000029490
• Secondary ID: U54AG063546
• Status: Completed
• Start date: March 1, 2021
• Est. completion date: August 15, 2022

Study information

• Verified date: February 2024
• Source: Yale University
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

This is an observational study of the pragmatic implementation of an ED screening, outpatient referral, and care coordination process for older ED patients who may have UCID.

Description:

Embedded pragmatic, implementation pilot that incorporates training, ED assessment for delirium and dementia risk, referral of ED patients with undiagnosed cognitive impairment and dementia for primary care feedback and care recommendations. This pilot would gather observational data evaluating the feasibility of incorporating cognitive impairment screens into routine ED delirium assessments, and developing optimal work flow for identifying and referring ED patients with suspected (undiagnosed) dementia for confirmatory evaluation and care coordination.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 100
• Est. completion date: August 15, 2022
• Est. primary completion date: August 15, 2022
• Accepts healthy volunteers: No
• Gender: All
• Age group: 65 Years and older

Eligibility

Inclusion Criteria:

• Adults age 65 or older

• Discharged from the adult ED at YNHH or the ED at NMH

Exclusion Criteria:

• Documented or known history of dementia

• Alcohol/substance intoxication while in the ED

• Non-English or Non-Spanish speaking

Related Conditions & MeSH terms

• Cognitive Impairment
• Delirium
• Dementia
• Emergencies
• Emergency Care

Intervention

Diagnostic Test:
• PD4ED 3-step intervention (ED assessment, outpatient assessment, Brain health plan)
ED assessment for suspected dementia. positive ED patients referred for outpatient clinic cognitive impairment assessment. positive clinic patients referred to primary care with brain health patient plan.

Locations

Country	Name	City	State
United States	Northwestern	Chicago	Illinois
United States	Yale New Haven Hospital	New Haven	Connecticut

Sponsors (2)

Lead Sponsor	Collaborator
Yale University	National Institute on Aging (NIA)

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Percentage of Patients With Confirmed Delirium or Dementia	percentage of patients discharged from ED positive for delirium or dementia among total number of patients 65+	1 year
Primary	Rates of Outpatient Assessment Referral of Patients With Suspected Dementia	number of patients with appointment to Alzheimer's Dementia Centers or geriatrics outpatient clinic / number of patients given information sheet or referred to outpatient clinic	30 days
Primary	Number of Participants Diagnosed With Dementia Among Those With Completed Outpatient Assessment	number of patients diagnosed with dementia (all categories) among those that completed the outpatient assessment	Up to 100 days from ED discharge
Primary	Rates of Connection With Primary Care	number of patients with PCP follow-up about brain health plan of the number of patients with outpatient confirmation of Dementia or MCI	30 days