Implementation and Evaluation of the COTiD Program in the Netherlands

NCT01117285 | Unknown DMC

• 1 other identifier: 80-82315-98-090010
• Study Type: interventional
• Target: 180
• Locations: 1 country
• Sites: 1

Brief Summary

The main purpose of this cluster randomized controlled trial is to evaluate the difference in effectiveness between a combined implementation strategy and an educational strategy on the implementation of a community occupational therapy program for clients with dementia and their primary caregivers.

Conditions

Dementia

Keywords

Occupational Therapy; Evidence-Based Practice; Continuing Education; utilization; Guideline; Dementia; Guideline implementation

Outcome Measures

Primary Outcomes (3)

• Adherence of occupational therapists to the COTiD program

  Adherence is measured using vignettes. Vignettes are realistic case descriptions about which occupational therapists are asked to answer open ended questions.

  one year (baseline, T1, and T2)

• Community occupational therapy use according to the COTiD program

  Community OT use reflects: * How many people with dementia were referred to OT services in total * How many people with dementia were referred specifically to OT according to the COTiD program.

  one year

• Costs of the implementation strategies

  The following cost data is collected: Costs of the implementation strategies * Costs made by the OTs, managers, and physicians receiving the combined implementation strategy. * Costs made by the OTs receiving only the educational strategy. * Development and execution costs of the combined implementation strategy. * development and execution costs of the educational strategy. Costs made buy the cliënt and caregiver * Costs made by client and caregiver (using the RUD Lite instrument)regarding healthcare consumption * Time the caregiver spends om informal care

  October 2009 - December 2011

Secondary Outcomes (2)

• Knowledge of the healthcare professionals about the COTiD program

  one year (baseline, T1, and T2)

• COTiD program treatment outcome on client and caregiver level

  one year (baseline, T1, and T2)

Study Arms (2)

3-day post-graduate course

ACTIVE COMPARATOR

3-day post-graduate course on the use of the COTiD program in clinical practice

Other: 3-day post-graduate course

Combined implementation strategy

EXPERIMENTAL

The combined implementation strategy

Other: Combined implementation strategy

Interventions

3-day post-graduate course OTHER

A 3-day course in using the COTiD program in clinical practice. The 3 days are not provided uninterrupted but there are at least two weeks between each day to provide time to practice with the guideline (for discussion on the 2nd day). The course consists of theory on the content of the guideline and its effectiveness, Practice parts of the guideline by rol playing, and discussing each others skills through watching video material.

Also known as: educational strategy

3-day post-graduate course

Combined implementation strategy OTHER

The combined implementation strategy provides strategies for occupational therapists (OTs), physicians, and managers. OTs receive: * 3-day post-graduate course * 2 extra training days: Lectures and skills practice focused on using the COTiD program and promoting the use of the program within their organization and network. * Coaching on the job: Barriers to using the COTiD program in practice are discussed using motivational interviewing. * Discussion platform * Web-based registration system: Provides guidance in using the COTiD program for every individual client. * Regional meetings: successes and difficulties in using the COTiD are discussed. Managers and physicians receive: * Information on the COTiD program through a website and newsletters. * Motivational reminders.

Also known as: implementation training

Combined implementation strategy

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may not qualify if:

• Criteria for clusters
• The organization provides outpatient OT.
• The organization expects that they will be able to include a minimum of 8 clients in the study.
• There are at least two OTs, one manager, and one physician willing and able to participate in the study.
• The organization does not provide OT or outpatient treatment and is not allowed to refer to OT services in their area that do provide community OT.
• Less than 8 clients are available per year to refer to the OT.
• Physicians, managers or OTs are not willing to participate
• Members of the board of directors responsible for the organization do not agree to participate
• Criteria for client with dementia and their informal caregiver
• Client has mild to moderate dementia (MMSE score 10-24, DSM IV criteria for dementia)
• Client lives at home
• Client has an informal caregiver who takes care of the client at least twice a week
• Client is in a severe stage of dementia
• Client has a depression (GDS (version 30) \>12)
• Client has severe behavioral or psychological symptoms in dementia (BPSD)

Sponsors & Collaborators

• ZonMw: The Netherlands Organisation for Health Research and Development: lead
• HAN University of Applied Sciences: collaborator

Study Sites (1)

Radboud University Nijmegen Medical Centre, Scientific Institute for Quality of Healthcare (IQ healthcare) (and 45 Dutch organisation)

Nijmegen, Gelderland, 6500 HB, Netherlands

Location

Related Publications (7)

• Graff MJ, Vernooij-Dassen MJ, Thijssen M, Dekker J, Hoefnagels WH, Rikkert MG. Community based occupational therapy for patients with dementia and their care givers: randomised controlled trial. BMJ. 2006 Dec 9;333(7580):1196. doi: 10.1136/bmj.39001.688843.BE. Epub 2006 Nov 17.

  PMID: 17114212 BACKGROUND

• Graff MJ, Adang EM, Vernooij-Dassen MJ, Dekker J, Jonsson L, Thijssen M, Hoefnagels WH, Rikkert MG. Community occupational therapy for older patients with dementia and their care givers: cost effectiveness study. BMJ. 2008 Jan 19;336(7636):134-8. doi: 10.1136/bmj.39408.481898.BE. Epub 2008 Jan 2.

  PMID: 18171718 BACKGROUND

• Voigt-Radloff S, Graff M, Leonhart R, Schornstein K, Vernooij-Dassen M, Olde-Rikkert M, Huell M. WHEDA study: effectiveness of occupational therapy at home for older people with dementia and their caregivers--the design of a pragmatic randomised controlled trial evaluating a Dutch programme in seven German centres. BMC Geriatr. 2009 Oct 2;9:44. doi: 10.1186/1471-2318-9-44.

  PMID: 19799779 BACKGROUND

• Graff MJ, Vernooij-Dassen MJ, Thijssen M, Dekker J, Hoefnagels WH, Olderikkert MG. Effects of community occupational therapy on quality of life, mood, and health status in dementia patients and their caregivers: a randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2007 Sep;62(9):1002-9. doi: 10.1093/gerona/62.9.1002.

  PMID: 17895439 BACKGROUND

• Dopp CM, Graff MJ, Teerenstra S, Olde Rikkert MG, Nijhuis-van der Sanden MW, Vernooij-Dassen MJ. Effectiveness of a training package for implementing a community-based occupational therapy program in dementia: a cluster randomized controlled trial. Clin Rehabil. 2015 Oct;29(10):974-86. doi: 10.1177/0269215514564699. Epub 2014 Dec 28.

  PMID: 25547113 DERIVED

• Dopp CM, Graff MJ, Teerenstra S, Nijhuis-van der Sanden MW, Olde Rikkert MG, Vernooij-Dassen MJ. Effectiveness of a multifaceted implementation strategy on physicians' referral behavior to an evidence-based psychosocial intervention in dementia: a cluster randomized controlled trial. BMC Fam Pract. 2013 May 30;14:70. doi: 10.1186/1471-2296-14-70.

  PMID: 23718565 DERIVED

• Dopp CM, Graff MJ, Teerenstra S, Adang E, Nijhuis-van der Sanden RW, Olderikkert MG, Vernooij-Dassen MJ. A new combined strategy to implement a community occupational therapy intervention: designing a cluster randomized controlled trial. BMC Geriatr. 2011 Mar 30;11:13. doi: 10.1186/1471-2318-11-13.

  PMID: 21450063 DERIVED

MeSH Terms

Conditions

Dementia; Patient Acceptance of Health Care

Condition Hierarchy (Ancestors)

Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurocognitive Disorders; Mental Disorders; Treatment Adherence and Compliance; Health Behavior; Behavior

Study Officials

• Myrra Vernooij-Dassen, PhD

  Radboud University Medical Center

  STUDY CHAIR

• Maud Graff, PhD

  Radboud University Medical Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: May 3, 2010
• First Posted: May 5, 2010
• Study Start: October 1, 2009
• Primary Completion: December 1, 2011
• Study Completion: December 1, 2011
• Last Updated: May 21, 2010

Record last verified: 2010-03

Locations

NL (1)