The Primary Care - Dementia Assessment and Treatment Algorithm (PC-DATA)

This study is currently recruiting participants.
Verified August 2013 by Queen's University
Sponsor:
Collaborator:
Canadian Institutes of Health Research (CIHR)
Information provided by (Responsible Party):
Dallas Seitz, Queen's University
ClinicalTrials.gov Identifier:
NCT01548053
First received: February 29, 2012
Last updated: August 13, 2013
Last verified: August 2013
  Purpose

Alzheimer's disease (AD) and related forms of dementia currently affect over 400,000 individuals in Canada and the numbers of community dwelling older adults with AD is rapidly growing. AD is associated with over $15 billion annually in care costs. Most individuals with AD are under the care of primary care providers (PCPs) including family physicians and primary care nurses. The evaluation and management of AD is challenging for PCPs and the quality of care provided to older adults with AD by PCP could be improved which would optimize outcomes for this vulnerable population. Provision of quality care to older adults with AD involves implementation of best practices as outlined in guidelines such as the Canadian Consensus Conference Guidelines on the Diagnosis and Treatment of Dementia. Utilizing a group of dementia researchers, PCPs, other knowledge users, and individuals affected by AD, this project will develop practical, clinically relevant resources for primary care physicians and nurses to aid in the evaluation of older adults with AD. A knowledge tool, the Primary Care - Dementia Assessment and Treatment Algorithm (DATA Tool) will be introduced into several primary care settings in Ontario using educational sessions with PCP with additional support from internet resource and a dementia care manager. The quality of dementia care provided to older adults newly diagnosed with AD will be assessed in the three years preceding the intervention compared to the year following the implementation. This project will also describe the process of knowledge exchange with PCPs, including potential barriers and facilitators of knowledge uptake and examine if the care provided during the intervention was patient-centred through interviews with patients and caregivers.

Research Objectives:

  1. Develop knowledge tools to facilitate assessment and treatment of AD by PCPs based on best evidence;
  2. Transfer these knowledge tools into a variety of primary care settings in Ontario; and,
  3. Evaluate the effects of this intervention on dementia quality of care, PCP application of knowledge, and the patient-centeredness of care.

Condition Intervention
Dementia
Alzheimer's Disease
Other: PC-DATA tool

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Health Services Research
Official Title: A Study Evaluating the Effects of a Primary Care - Dementia Assessment Treatment Algorithm on the Quality of Care Provided to Older Adults With Dementia in Primary Care Settings

Resource links provided by NLM:


Further study details as provided by Queen's University:

Primary Outcome Measures:
  • Change in number of dementia care process quality indicators achieved. [ Time Frame: 1 year following implementation ] [ Designated as safety issue: No ]
    The evaluation of quality indicators (QI) using chart audit data will be undertaken following initial assessment of dementia will be used to assess the quality of care provided to individuals with dementia. The change in number of QI satisfied following the intervention will be compared to a historical group of individuals assessed for dementia by each PCP in the 3 years preceding the intervention.


Secondary Outcome Measures:
  • Impact on learning and knowledge application [ Time Frame: Approximately 9 months following intervention ] [ Designated as safety issue: No ]
    Qualitative interviews with family physicians and interprofessional primary care professional will be conducted using a grounded theory design will be conducted with primary care providers to identify key conceptual, contextual and process elements involved in the exchange and application of dementia-specific knowledge in the primary care context.

  • Client-centred care [ Time Frame: Approximately 9 months following intervention ] [ Designated as safety issue: No ]
    Interviews will be conducted with patients and careviers to seek to identify key elements of patient-centred care.


Estimated Enrollment: 135
Study Start Date: March 2012
Estimated Study Completion Date: March 2014
Estimated Primary Completion Date: March 2014 (Final data collection date for primary outcome measure)
Intervention Details:
    Other: PC-DATA tool
    The implementation plan consists of educational sessions and a dementia care manager (DCM). The educational sessions consist of two components: a 1.5 hour group-based DATA tool implementation workshop with primary care providers (PCPs); and, a 1 hour follow-up session at study mid-point. The DCM will facilitate application of the DATA tool and provide direct support to PCPs during the study.
  Eligibility

Ages Eligible for Study:   60 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Primary Care Provider Inclusion Criteria:

  • Primary care provider at participating sites

Primary Care Provider Exclusion Criteria:

  • primary care provider at non-participating site

Patient Inclusion Criteria:

  • Community-dwelling at time of initial presentation to primary care provider
  • Age 60 years or older at time of initial assessment by primary care provider
  • Presenting to primary care providers with cognitive or functional symptoms suggestive of Alzheimer's disease or other form of dementia
  • Patient must have a caregiver or substitute decision maker

Patient Exclusion Criteria:

  • Prevalent cases of dementia will be excluded from study population
  • Individuals with dementia residing in long-term care or nursing homes
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01548053

Contacts
Contact: Dallas P Seitz, MD 613-548-5567 ext 5942 seitzd@providencecare.ca

Locations
Canada, Ontario
Queen's University Recruiting
Kingston, Ontario, Canada, K7L 3N6
Contact: Dallas P Seitz, MD    613-548-5567 ext 5942    seitzd@providencecare.ca   
Sponsors and Collaborators
Queen's University
Canadian Institutes of Health Research (CIHR)
Investigators
Principal Investigator: Dallas P Seitz, MD Queen's University
  More Information

No publications provided

Responsible Party: Dallas Seitz, Assistant Professor, Queen's University
ClinicalTrials.gov Identifier: NCT01548053     History of Changes
Other Study ID Numbers: PC-DATA1
Study First Received: February 29, 2012
Last Updated: August 13, 2013
Health Authority: Canada: Canadian Institutes of Health Research

Keywords provided by Queen's University:
Primary care
Dementia
Knowledge translation
Quality of care
Qualitative methods
Alzheimer's disease

Additional relevant MeSH terms:
Alzheimer Disease
Dementia
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Tauopathies
Neurodegenerative Diseases
Delirium, Dementia, Amnestic, Cognitive Disorders
Mental Disorders

ClinicalTrials.gov processed this record on April 17, 2014