Promoting Goals-of-Care Discussions for Patients With Memory Problems and Their Caregivers

Launched by UNIVERSITY OF WASHINGTON · Oct 24, 2022

Keywords

ClinConnect Summary

This clinical trial is focused on improving communication between doctors, patients with memory problems, and their family members. The researchers want to see if a simple tool called the "Jumpstart Guide" can help doctors have better conversations about what patients want for their healthcare. They will compare patients whose doctors received this guide before their visit to those whose doctors did not, to find out if the guide helps more patients discuss their healthcare goals.

To be eligible for this study, patients need to be at least 55 years old, receive care at a UW Medicine clinic, and have a diagnosis of a specific type of dementia recorded in their medical records. Family members who help care for these patients can also participate if they are 18 or older and speak English. Participants will fill out surveys after their clinic visits to share their experiences. It's important to note that not all patients will have a qualifying family member to join the study. Overall, this trial aims to improve the quality of conversations about care for patients with memory issues and their families.

Gender

ALL

Eligibility criteria

• • PATIENTS
• Inclusion Criteria:
• • Be cared for as an outpatient at a UW Medicine clinic
• • 55 years of age or older
• • Have an ICD-10 code for ADRD documented in the EHR within the prior two years
• • If patients are cared for in a primary care setting within UW Medicine or by a geriatrician or neurologist, only a diagnosis of ADRD is required for eligibility.
• • If patients have ADRD and are not followed by a primary care clinician at UW Medicine but are followed by a subspecialist, eligible patients must also have an ICD-10 code for one or more of seven chronic conditions used by the Dartmouth Atlas, relevant for the specialist they see, to ensure that goals-of care discussions are applicable for these specialists in the care of the enrolled patient. These conditions by specialist are: malignant cancer/leukemia (oncologist), chronic pulmonary disease (pulmonologist), coronary artery disease or heart failure (cardiologist), chronic liver disease (hepatologist), chronic renal disease (nephrologist), and diabetes with end-organ damage (endocrinologist).
• Exclusion Criteria:
• • restricted status, legal or risk management concerns
• • without capacity to complete informed consent procedures and without a legal surrogate to enroll them (for the survey component or qualitative interviews)
• • non-English speaking (for the survey component or qualitative interviews)
• • FAMILY MEMBERS
• Inclusion Criteria:
• • Identified (via the patient or the EHR) as the person most involved in care for an eligible patient in the trial
• • 18 years of age or older
• • English language proficiency
• Exclusion Criteria:
• • legal or risk management concerns
• • psychological illness or morbidity preventing completion of study materials
• • physical or mental limitations preventing completion of study materials
• • non-English speaking
• • Not all patients will have an eligible family member to enroll.
• • CLINICIANS
• Inclusion Criteria:
• • Physician or advance practice provider caring for older adults within UW Medicine clinics
• • 18 years of age or older
• • English language proficiency
• • (Interviews) Identified as clinician of record for an enrolled patient in the trial and received a Jumpstart guide
• Exclusion Criteria:
• • legal or risk management concerns