Alzheimer Disease Clinical Trial
— PHARMAIDOfficial title:
Evaluation of the Impact of Personalized Pharmaceutical Collaborative Care Integrated to a Multidisciplinary Psychosocial Program on the Burden Felt by Caregivers of Elderly Patients With Alzheimer's Disease and Related Disorders and Evaluated at 18-month Follow-up
NCT number | NCT02802371 |
Other study ID # | 69HCL14_0450 |
Secondary ID | |
Status | Recruiting |
Phase | N/A |
First received | |
Last updated | |
Start date | August 2016 |
Est. completion date | February 2020 |
Caring for patients with Alzheimer Disease or Related Disorders (ADRD) is accompanied with a
caregiver burden that increases with the progression of the disease. This burden can have
physical, psychological, emotional, social and financial issue on the informal caregivers who
are often represented as hidden secondary patients. They frequently have a higher risk of
developing mood disorders as depression, anxiety, stress, sleep disorders and a lower quality
of life associated with a greater use of psychotropic drugs. They also incur higher risk of
heart disease and mortality. The embrittlement of the caregiver is a major factor of early
institutionalization of patient. In the PIXEL study, the mean age of the men caregivers was
73.9 years and 64.8 for the women caregivers. Elderly themselves, especially spouses, the
informal caregivers are also exposed to common chronic diseases and associated polypharmacy
with a higher risk of developing drug-related problems due to aging and negligence of their
own health care. These risks are increased mainly in the elderly because of changes in
pharmacokinetic and pharmacodynamic parameters related to aging, acute or chronic diseases
and the potentially inappropriate prescription (PIP). Previous studies have shown the
effectiveness and positive impact of optimization of the therapeutics by a clinical
pharmacist on the reduction of drug-related problems, length of hospital stay, readmission
rates, quality of life and mortality. The patient's medication management is usually
delegated to the informal caregiver, who must also manage his own treatment. The caregiver
may face difficulties with therapeutics (e.g., inappropriate dosage form, adverse effects and
patient refusal) that could impact on its compliance with treatment or that of his relative.
No previous study has evaluated the impact of pharmaceutical collaborative care including
personalized interview with a clinical pharmacist and optimization of drug prescribing among
patients with ADRD and their caregivers.
However, many studies have assessed the effectiveness of non-pharmacological interventions on
caregiver burden, mood disorders and the patient institutionalization. Meta-analysis showed a
moderate improvement of the caregiver burden.
The main objective of the PHARMAID study is to measure the impact of personalized
pharmaceutical collaborative care integrated to a multidisciplinary psychosocial program on
the burden of ADRD caregivers and assessed at 18-month follow-up.
Status | Recruiting |
Enrollment | 240 |
Est. completion date | February 2020 |
Est. primary completion date | February 2020 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 65 Years and older |
Eligibility |
Inclusion Criteria: for the patients: - Patients aged 65 and over; - Patients with ADRD; - Patients suffering from mild to moderate stages of the disease, defined by the Mini-Mental Score Examination (MMSE), with scores of 25 to 16/30; - Patients living at home; - Patients received in a geriatric or memory consultation of a study recruiting centers; - Patients with the ability to express themselves orally or in writing in French sufficiently to carry out clinical assessments; - Patients who are not opposed to the research; for the caregivers: - Caregivers aged 55 and over; - Nonprofessional caregivers living with the patient or providing support to him/her at least 10 hours a week for the activities of daily living; - Caregivers with the ability to follow the program at the discretion of the investigator; - Caregivers with the ability to express themselves orally or in writing in French sufficiently to carry out clinical assessments; - Caregivers who are not opposed to the research. Exclusion Criteria: for the patients: - Institutionalized patients. for the caregivers: - Caregivers involved in another support program for the caregivers; - Caregivers whose the level of acceptance of the disease does not allow the participation in the study. |
Country | Name | City | State |
---|---|---|---|
France | Pharmacy unit and Clinical Research Center VCF (" Aging Brain Frailty ") University hospital of Lyon, Charpennes Hospital / University Lyon / INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center | Villeurbanne |
Lead Sponsor | Collaborator |
---|---|
Hospices Civils de Lyon |
France,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | caregiver's burden | The caregiver burden is measured using the Zarit Burden Index (ZBI) questionnaire. The ZBI is a subjective measure of burden that includes 22 items exploring the caregiver's perception and feelings about care situations. Each item was evaluated using a 5-point Likert scale ranging from 0 (never) to 4 (almost always), which are summed. The score range is 0-88, a higher score indicating a higher burden level. | Change from Baseline at 18-months follow-up | |
Secondary | caregiver's quality of life | Quality of life measured by questionnaire EUROQOL 5D | Change from Baseline at 18-months follow-up | |
Secondary | caregiver's anxiety | anxiety measured by scale HARD | Change from Baseline at 18-months follow-up | |
Secondary | caregiver's depression | depression measured by Geriatric Depression Scale (GDS) | Change from Baseline at 18-months follow-up | |
Secondary | patient's quality of life | Quality of life measured by questionnaire Alzheimer Disease Related Quality of Life (ADRQL scale) | Change from Baseline at 18-months follow-up | |
Secondary | patient's behavioral disorders | behavioral disorders measured by questionnaire Neuropsychiatric Index (NPI) | Change from Baseline at 18-months follow-up | |
Secondary | patient's functional autonomy | functional autonomy measured by IADL scale (Instrumental Activities of Daily Living) | Change from Baseline at 18-months follow-up | |
Secondary | Occurrence of medical consultation | number of medical consultation in patients and caregivers | Change from Baseline at 18-months follow-up | |
Secondary | Occurrence of recourse to emergency service | occurrence of recourse to emergency service in patients and caregivers | Change from Baseline at 18-months follow-up | |
Secondary | Occurrence of hospitalizations | number of hospitalization in patients and caregivers | Change from Baseline at 18-months follow-up | |
Secondary | Occurrence of admission in institution | occurrence of admission in institution in patients | Change from Baseline at 18-months follow-up |
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