Implementation of a Telehealth Palliative Care Model for Persons With Dementia

NCT05001620 | Completed Results DMC

• 2 other identifiers: HP-00095001U54AG063546
• Study Type: interventional
• Target: 16
• Locations: 1 country
• Sites: 1

Brief Summary

Grounded in the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) Model, this study will assess the implementation outcomes of the Nurse Practitioner (NP) delivered telehealth Palliative Care Consultation in Post-Acute Care (PCC-PAC) intervention for persons living with dementia (PLWD) and their care-partners newly admitted to nursing homes (NHs) for post-acute care.

Conditions

Palliative Care; Dementia

Keywords

Dementia; Palliative Care; Telehealth; Nursing Homes

Outcome Measures

Primary Outcomes (1)

• Adherence to Skilled Nursing Facility (SNF)-PCC Recommendations

  Investigators will determine a recommendation adherence score after each participants' encounter. Each recommendation will be assigned 2 points, then will define full (2 points), partial (1 point) and no adherence (0 point) to each recommendation. Investigators will sum the points for each SNF-PCC recommendation and use this as the denominator. Investigators will sum each recommendation with full, partial, no adherence and use this as the numerator. The fraction will be converted to a percentage ranging from 0-100% reflecting the recommendation adherence score.

  30 days post admission

Secondary Outcomes (1)

• Number of Hospitalizations

  30 days post admission

Other Outcomes (1)

• Number of Participants With Completed Stakeholder Interviews/Focus Groups

  1 year

Study Arms (2)

Palliative Care Consultation in Post-Acute Care

EXPERIMENTAL

Subjects will receive usual care plus a telehealth palliative care consultation by specialty providers who will document their findings in the Electronic Health Record (EHR), and communicate their findings and recommendations to the clinical team.

Other: Palliative Care Consultation

Stakeholder Engagement

NO INTERVENTION

We will engage stakeholders in a stakeholder engagement plan that include Palliative Care providers; Social Work (SW) NH champions; post-acute care unit nursing staff and providers (including medial directors); NH leadership, information technology staff; and a PLWD and their care partners in focus groups and one on one semi structured interviews via phone or videoconference.

Interventions

Palliative Care Consultation OTHER

The PC provider conducts the structured PCC-PAC via videoconference or telephone with the PLWD and/or their care partner and the social work (SW) champion in the NH. The SW and PC provider will set up a mutually agreed upon consultation day/time with the PLWD and/or care partner, within 5 business days of NH admission and follow up visits will occur no more than 30 days later (if needed).

Palliative Care Consultation in Post-Acute Care

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Stakeholders:
• (1) PC provider
• (2) Social Work (SW) NH champions
• (3) post-acute care unit nursing staff and providers (including medical directors)
• (4) NH leadership, information technology staff
• (5) PLWD and their care partner(s).
• Person Living with Dementia (PLWD)
• documented dementia diagnosis
• admitted for post-acute care
• age ≥ 60 years
• if unable to participate in a conversation or lacking capacity to make healthcare decisions as determined by the NH staff/providers, a care partner who can act as a surrogate decision maker in the PCC-PAC.

You may not qualify if:

• Stakeholders:
• PLWD who receives the intervention
• PLWD:
• planned discharge within 48 hours of screening
• currently receiving hospice care

Sponsors & Collaborators

• University of Maryland, Baltimore: lead
• National Institute on Aging (NIA): collaborator

Study Sites (1)

Collingswood Rehabilitation and Healthcare Center

Rockville, Maryland, 20850, United States

Location

MeSH Terms

Conditions

Dementia

Condition Hierarchy (Ancestors)

Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurocognitive Disorders; Mental Disorders

Limitations and Caveats

Despite multiple, iterative adaptations to implementation, including recruiting new sites and clinical partners, we were unable to enroll the targeted 30 patients in the trial. Two PLWD enrolled in the clinical trial, one completed the study.

Results Point of Contact

• Title: Dr. Joan G. Carpenter
• Organization: University of Maryland School of Nursing

joan.carpenter@umaryland.edu

443-880-1430

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: July 27, 2021
• First Posted: August 12, 2021
• Study Start: August 4, 2021
• Primary Completion: July 1, 2023
• Study Completion: July 1, 2023
• Last Updated: August 13, 2024
• Results First Posted: August 13, 2024

Record last verified: 2024-07

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)