Anticipating Decline and Providing Therapy

Launched by WAKE FOREST UNIVERSITY HEALTH SCIENCES · Dec 13, 2023

Keywords

ClinConnect Summary

This clinical trial, called "Anticipating Decline and Providing Therapy" (ADAPT), is studying how to support older adults who have been discharged from the Intensive Care Unit (ICU). The goal is to compare the usual care that patients receive after leaving the ICU with a special program designed to screen for cognitive issues and provide additional support. Researchers are looking to enroll 120 participants aged 60 and older who have experienced confusion (delirium) during their ICU stay. To be eligible, participants must have stayed in the ICU for at least 72 hours and be able to speak English.

If you or a loved one qualifies for this study, you would be randomly assigned to either receive standard care or participate in the ADAPT program, which includes screening for cognitive problems and tailored support. This may involve follow-up phone calls to check in on your mental health and provide necessary resources. It's important to know that the study is currently recruiting participants, and your involvement could help improve care for other older adults in similar situations. Remember, this study will only include those who meet specific criteria, such as not having severe ongoing health issues or previous dementia history.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Age 60 and older at time of discharge from intensive care unit
• • Minimum 72 hour Intensive Care Unit stay in an ICU at Atrium Health Wake Forest Baptist
• • Delirium during ICU stay as determined by positive Confusion Assessment Method (CAM)-ICU score, review of clinical - documentation, or discussion with clinical team
• • Primary care provider in the Atrium Health Wake Forest system or intention to follow with Primary Care Physician in Atrium Health system
• • English speaking
• Exclusion Criteria:
• • Death during initial hospitalization and/or discharge to Hospice
• • Life-expectancy \< 6 months from pre-existing illness (defined as diagnosis of metastatic cancer, cirrhosis, advanced heart failure, prior palliative care referral)
• • Acute Traumatic Brain Injury
• • Continued residence in skilled nursing facility or rehab that prevents ability to complete study telephone call at time of first cognitive screen attempt
• • Prior history of dementia in electronic health record
• • Language or communication barrier that prohibits intervention participation
• • Participant cannot identify family or caregiver contact or family/caregiver unwilling to participate
• • Subject or legally authorized representative (LAR) decline consent
• • Unstable telephone service for contact after hospital discharge
• • Primary residence outside of North Carolina