Pilot Pragmatic Clinical Trial to Embed Tele-Savvy Into Health Care Systems

Alzheimer Disease Clinical Trial

Official title:

Pilot Pragmatic Clinical Trial to Embed Tele-Savvy Into Health Care Systems

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05080777
• Other study ID #: U21-139-2
• Status: Completed
• Phase: N/A
• Start date: September 28, 2021
• Est. completion date: June 5, 2023

Study information

• Verified date: June 2023
• Source: UConn Health
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This cluster randomized pragmatic clinical trial will test the effectiveness and feasibility of embedding the Tele-Savvy intervention, a psychoeducational program for family and other informal caregivers of older adults living in the community with Alzheimer's disease and related dementia (ADRD), in two health care systems/clinical sites: UConn Health in Farmington, Connecticut, and Emory Healthcare in Atlanta, Georgia.

Description:

This cluster randomized pragmatic clinical trial will test the effectiveness and feasibility of embedding the Tele-Savvy intervention, a psychoeducational program for family and other informal caregivers of older adults living in the community with Alzheimer's disease and related dementia (ADRD), in two health care systems/clinical sites: UConn Health in Farmington, Connecticut, and Emory Healthcare in Atlanta, Georgia. A total of 100 caregivers, 50 at each study site, will participate in this pilot study. At each site, 30 caregivers will be randomly assigned to receive the Tele-Savvy intervention, and 20 caregivers will be randomly assigned to receive the self-guided Caregiving During Crisis online program.

All 100 caregivers will complete identical self-administered questionnaires to measure the caregiver-specific outcome measures in this pilot study. Outcome measures will include caregiver mastery (primary outcome), caregiver response to specific memory and behavioral problems, and caregiver stress. Also, we will employ process measures of participation and engagement in the interventions for caregivers in both arms of the trial, as well as implementation outcomes via surveys with clinicians and Information Technology staff at each of the two clinical sites responsible for programming electronic medical records to enable capture and storage of caregiver outcomes.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 76
• Est. completion date: June 5, 2023
• Est. primary completion date: June 5, 2023
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 110 Years

Eligibility

Inclusion Criteria:

• Identified by EHR systems and confirmed by a health care provider as a family member or unpaid significant other who provides care at home for an older adult (age 65 or older) living with ADRD

• English speaking

• Able to understand study procedures and comply with them for the entire length of the study

• Access to appropriate video and audio technology to be able to participate in interventions

Exclusion Criteria:

• Unwilling to be randomized to receive either Tele-Savvy or Caregiving During Crisis

• Planning to admit the person living with ADRD to a nursing home on a long-term basis within 6 months of randomization.

Related Conditions & MeSH terms

• Alzheimer Disease
• Brain Diseases
• Central Nervous System Diseases
• Dementia
• Mental Disorders
• Nervous System Diseases
• Neurocognitive Disorders
• Neurodegenerative Diseases
• Tauopathies

Intervention

Behavioral:
• Tele-Savvy
A low-risk, psychoeducational, group-based intervention, is grounded in social learning and stress process theory and its main goal is to produce improved caregiver mastery over the symptom management skills commonly encountered when supervising and caring at home for an older adult living with ADRD. Over the 7-week program, there are synchronous and asynchronous activities each week. The synchronous portion includes weekly scheduled videoconferences (60-80 min) that serve as an online classroom in which facilitators lead lectures and discussions. Daily, caregivers access online 6- to 15-min prerecorded videos, each focused on one main learning objective. Caregivers can watch the lessons whenever and as often as they wish.
• Caregiving During Crisis (Educational Program)
The attention control group will receive the self-guided Caregiving During Crisis program. Caregiving During Crisis is a fully online, asynchronous, professionally designed continuing education course aimed at developing the competency of informal caregivers of community-dwelling persons living with dementia to ensure the safety of that person and themselves during this time of the COVID-19 pandemic. The course, readily accessible by home computer or smartphone, describes methods of home infection control and prevention to create a Safe Home space, strategies for safely leaving and re-entering the home (e.g., to shop), additional strategies for safely allowing service personnel (e.g., home health aides or electricians) and select family members to enter the Safe Home space, and risk management strategies to frame decisions when/if COVID restrictions are relaxed or revoked.

Locations

Country	Name	City	State
United States	Emory HealthCare (IMCC)	Atlanta	Georgia
United States	UConn Health (Geriatrics Associates)	Farmington	Connecticut

Sponsors (2)

Lead Sponsor	Collaborator
UConn Health	Emory University

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in Caregiver Mastery	Measured using a 4-item self-perceived caregiving competence scale.	pre-randomization; 3 months post-randomization; and 6 months post-randomization
Secondary	Change in Caregiver Reactions	The reactions caregivers have to the behavioral and psychological symptoms expressed by persons living with dementia, using the Revised Memory and Behavior Problem Checklist (RMBPC). The RMBPC is a 24-item scale capturing caregiver reactions to 24 memory and behavior problems. Scores are computed based on the presence or absence of each problem first, and then for caregiver "reaction" or the extent to which caregivers were "bothered" or "upset" by each behavior.	pre-randomization; 3 months post-randomization for all; and 6 months post-randomization
Secondary	Change in Caregiver Stress	The Perceived Stress Scale (PSS) will be used to quantify caregiver stress levels. The PSS is a 14-item measure. Higher score reflects higher perceived stress	pre-randomization; 3 months post-randomization for all; and 6 months post-randomization