Patient Priorities Care for Hispanics With Dementia

NCT05303194 | Completed Results DMC

• 1 other identifier: 21-0107
• Study Type: interventional
• Target: 21
• Locations: 1 country
• Sites: 1

Brief Summary

Most persons living with dementia (PlwD) have multiple chronic conditions (MCC). Managing MCC typically involves adhering to clinical practice guidelines for single diseases. This approach often results in burdensome care that usually does not reflect what matters most to patients. To address the challenges of caring for patients with MCC, Patient Priorities Care (PPC) was developed - a process that aligns treatment recommendations with patient priorities rather than single-disease guidelines, to improve care. Successful completion of this pragmatic pilot project will help determine how to best embedded PPC in a Healthcare system that serves a large Hispanic population. The investigators will determine if the benefits previously reported with the use of PPC hold in Hispanics with dementia.

Conditions

Multiple Chronic Conditions; Dementia

Keywords

multiple chronic conditions; dementia; Hispanic

Outcome Measures

Primary Outcomes (1)

• Self-reported Perceived Value of Patient Priorities Care (PPC) Approach

  Participants were asked to grade how valuable they thought the PPC approach was. We report the percentage of participants who responded "valuable" or "very valuable" on a scale from 1 to 5 with 1 representing "not valuable" and 5 representing "very valuable".

  On average one month after baseline

Secondary Outcomes (1)

• Number of Participants With Documented Changes in the Electronic Health Record That Indicate Care Alignment Was Done

  Approximately one month after baseline

Study Arms (2)

Patient Priorities Care (PPC) Adaptation

OTHER

5 Hispanic patients with multiple chronic conditions (MCC) and no dementia. In order to adapt PPC for Hispanics with MCC, five Hispanics with MCC will go through the 2 parts of the PPC approach: 1) Priority setting; and 2) Care alignment.

Behavioral: Patient Priorities Care (PPC) Approach

PPC Feasibility Testing

OTHER

20 Hispanic patients with multiple chronic conditions (MCC), including dementia. In order to adapt PPC for Hispanics with MCC and dementia, twenty Hispanics with MCC and dementia will go through the 2 parts of the PPC approach: 1) Priority setting; and 2) Care alignment.

Behavioral: Adapted PPC

Interventions

Patient Priorities Care (PPC) Approach BEHAVIORAL

First, identify patient priorities, and second align care received with those priorities.

Patient Priorities Care (PPC) Adaptation

Adapted PPC BEHAVIORAL

First, identify patient priorities, and second align care received with those priorities.

PPC Feasibility Testing

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• A) For adaptation (n=5)
• Patient's primary care provider is located in the UTMB Geriatrics Outpatient Clinic in Galveston.
• Patient identifies as Hispanic.
• Patient speaks English or Spanish.
• Patient has multiple chronic conditions listed as diagnoses in their electronic health record (3 or more chronic conditions).
• Consent to participate in all parts of the study.
• Primary care provider agrees with participation. B) For feasibility testing (n=20)
• Patient's primary care provider is located in the UTMB Geriatrics Outpatient Clinic in Galveston.
• Patient identifies as Hispanic.
• Patient speaks English or Spanish.
• Patient has multiple chronic conditions listed as diagnoses in their electronic health record (3 or more chronic conditions).
• Patient has diagnosis of dementia.
• Have a caregiver willing to participate in the study.
• Patient consent if he/she has capacity as deemed by their primary care provider or assent if he/she doesn't have capacity.
• Caregiver consent.

You may not qualify if:

• A) For adaptation (n=5)
• Patient's primary care provider located at UTMB but not in the Geriatrics Outpatient Clinic.
• Non-Hispanic patients.
• Speaks language other than English or Spanish.
• Patient does not have multiple chronic conditions.
• Deemed ineligible by primary care provider.
• Patient has diagnosis of dementia. B) For feasibility testing (n=20)
• Patient's primary care provider located at UTMB but not in the Geriatrics Outpatient Clinic.
• Non-Hispanic patients.
• Speaks language other than English or Spanish.
• Patient does not have multiple chronic conditions.
• Patient doesn't have diagnosis of dementia.
• Patient deemed ineligible by primary care provider.
• Patient doesn't provide consent or assent based on capacity.
• Caregiver doesn't provide consent.

Sponsors & Collaborators

• The University of Texas Medical Branch, Galveston: lead
• The University of Texas Health Science Center, Houston: collaborator

Study Sites (1)

The University of Texas Medical Branch in Galveston

Galveston, Texas, 77555, United States

Location

Related Publications (5)

• Tinetti ME, Costello DM, Naik AD, Davenport C, Hernandez-Bigos K, Van Liew JR, Esterson J, Kiwak E, Dindo L. Outcome Goals and Health Care Preferences of Older Adults With Multiple Chronic Conditions. JAMA Netw Open. 2021 Mar 1;4(3):e211271. doi: 10.1001/jamanetworkopen.2021.1271.

  PMID: 33760091 BACKGROUND

• Freytag J, Dindo L, Catic A, Johnson AL, Bush Amspoker A, Gravier A, Dawson DB, Tinetti ME, Naik AD. Feasibility of Clinicians Aligning Health Care with Patient Priorities in Geriatrics Ambulatory Care. J Am Geriatr Soc. 2020 Sep;68(9):2112-2116. doi: 10.1111/jgs.16662. Epub 2020 Jul 20.

  PMID: 32687218 BACKGROUND

• Tinetti ME, Naik AD, Dindo L, Costello DM, Esterson J, Geda M, Rosen J, Hernandez-Bigos K, Smith CD, Ouellet GM, Kang G, Lee Y, Blaum C. Association of Patient Priorities-Aligned Decision-Making With Patient Outcomes and Ambulatory Health Care Burden Among Older Adults With Multiple Chronic Conditions: A Nonrandomized Clinical Trial. JAMA Intern Med. 2019 Dec 1;179(12):1688-1697. doi: 10.1001/jamainternmed.2019.4235.

  PMID: 31589281 BACKGROUND

• Blaum CS, Rosen J, Naik AD, Smith CD, Dindo L, Vo L, Hernandez-Bigos K, Esterson J, Geda M, Ferris R, Costello D, Acampora D, Meehan T, Tinetti ME. Feasibility of Implementing Patient Priorities Care for Older Adults with Multiple Chronic Conditions. J Am Geriatr Soc. 2018 Oct;66(10):2009-2016. doi: 10.1111/jgs.15465. Epub 2018 Oct 3.

  PMID: 30281777 BACKGROUND

• Naik AD, Dindo LN, Van Liew JR, Hundt NE, Vo L, Hernandez-Bigos K, Esterson J, Geda M, Rosen J, Blaum CS, Tinetti ME. Development of a Clinically Feasible Process for Identifying Individual Health Priorities. J Am Geriatr Soc. 2018 Oct;66(10):1872-1879. doi: 10.1111/jgs.15437. Epub 2018 Oct 3.

  PMID: 30281794 BACKGROUND

MeSH Terms

Conditions

Multiple Chronic Conditions; Dementia

Condition Hierarchy (Ancestors)

Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurocognitive Disorders; Mental Disorders

Results Point of Contact

• Title: Rafael Samper-Ternent
• Organization: The University of Texas Medical Branch

rasamper@utmb.edu

8322057994

Study Officials

• Aanand D Naik, MD

  The University of Texas Health Science Center, Houston

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: The study has two phases: 1) an initial adaptation phase; and 2) a feasibility testing phase. For the adaptation phase 5 Hispanics with multiple chronic condition and without dementia will be invited to participate. These participants will need to consent to be part of the study. For the second phase, the investigators will determine if participants with dementia have capacity by asking their primary care providers or by administering the telephone version of the Montreal Cognitive Assessment. If a score of less than 12 is obtained, the caregiver will be asked to consent for both participants.

Study Record Dates

• First Submitted: March 8, 2022
• First Posted: March 31, 2022
• Study Start: May 31, 2022
• Primary Completion: March 5, 2024
• Study Completion: October 30, 2024
• Last Updated: August 8, 2025
• Results First Posted: August 8, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR
• Time Frame: Once results have been submitted to clinicaltrials.gov the listed materials will be available to share with other researchers.
• Access Criteria: Data will be shared with researchers upon request to the Pi or Co-PI of the study.

Locations

US (1)