The Dementia Symptom Management at Home Program

Dementia Clinical Trial

— DSM-H  

Official title:

The Dementia Symptom Management at Home Program: A Bundled Interprofessional Intervention to Improve Dementia Patient-Caregiver Dyad Quality of Care and Quality of Life Through Home Healthcare.

Clinical Trial Details — Status: Withdrawn

Administrative data

• NCT number: NCT02482623
• Other study ID #: i14-01960
• Status: Withdrawn
• Phase: N/A
• Start date: August 1, 2017
• Est. completion date: March 1, 2018

Study information

• Verified date: September 2018
• Source: New York University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Persons with dementia and their caregivers are often cared for in the community through home healthcare (HHC). While these patients and their caregivers need significant help and often have difficulty maintaining their quality of life, home healthcare clinicians are often unprepared to care for this population. This study will therefore examine the ability of an integrated, multi-pronged evidence-based practice intervention for home healthcare registered nurses, occupational therapists and physical therapists, the DSM-H, to improve the quality of care and quality of life for persons with dementia and their family caregiver. The investigators will enroll persons with dementia and their family caregiver upon admission to the HHC agency and examine their quality of life over 60 days following admission, comparing those who receive the intervention to those who serve as controls.

Description:

The Dementia Symptom Management at Home (DSM-H) Program is an integrated bundled implementation science intervention to improve interprofessional care in home healthcare (HHC). It consists of training, assessment instruments, patient-caregiver centered care plans and workflow changes. The investigators will perform a cluster randomized controlled clinical trial at a single, urban, non-profit HHC agency, randomizing care teams to either be trained in performing the intervention or serve as controls. The aims of this program are to examine the efficacy of this program to: Aim 1: Measure the effects of DSM-H on pain, neuropsychiatric symptoms, and caregiver rated QOL in the person with dementia receiving HHC. Aim 2: Assess the effects of DSM-H on QOL, burden and depression for the informal caregiver of persons with dementia receiving HHC. Aim 3: Assess the effects of DSM-H on the number of emergency room visits and hospital admissions.

Recruitment information / eligibility

• Status: Withdrawn
• Enrollment: 0
• Est. completion date: March 1, 2018
• Est. primary completion date: March 1, 2018
• Accepts healthy volunteers: No
• Gender: All
• Age group: 65 Years and older

Eligibility

Inclusion Criteria:

• patient-caregiver dyad admitted to the HHC agency
• Patients must be 65 or older and speak English and/or Spanish.
• Patient must have an informal caregiver who is at least 18 years old and spends at least 8 hours per week with the patient.
• Patients must score greater than 4 on the cognitive subscale of the Healthy Aging Brain Care Monitor signifying at least mild impairment

Exclusion Criteria:

• Patients with concomitant axis I disorders other than dementia, depression, adjustment disorders, sleep disorders.
• Patients being seen only in the behavioral health unit without another skilled need.

Related Conditions & MeSH terms

• Dementia

Intervention

Behavioral:
• Dementia Symptom Management at Home Program
The DSM-H is a multi-modal interprofessional intervention that includes: 1. intensive training of clinician mentors; 2. disseminated online training for Registered Nurses, Physical Therapists, Occupational Therapists; 3. implementation of evidence-based care plans, assessment instruments, and teaching handouts.

Locations

Country	Name	City	State
United States	New York University College of Nursing	New York	New York
United States	The New Jewish Home	New York	New York

Sponsors (2)

Lead Sponsor	Collaborator
New York University	Visiting Nurse Service of New York

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Person With Dementia Quality of Life	Quality of Life in Alzheimer's Disease survey instrument	60 Days
Primary	Caregiver Quality of Life	Caregiver Targeted Quality of Life survey instrument	60 Days
Secondary	Person with Dementia Pain	Pain Assessment in Advanced Dementia or Brief Pain Inventory survey instrument	60 days
Secondary	Person with Dementia Neuropsychiatric Symptom Burden	Healthy Aging Brain Care Monitor survey instrument	60 days
Secondary	Caregiver Depression	Public Health Questionnaire-9 survey instrument	60 days
Secondary	Person with Dementia ER Visits	Resource Utilization Inventory survey instrument	30, 60 days
Secondary	Person with Dementia Hospital Admissions	Resource Utilization Inventory survey instrument	30, 60 days
Secondary	Person with Dementia Functional Status	Katz Activities of Daily Living and Lawton Instrumental Activities of Daily Living assessments	60 days