Improving PCP Advance Care Planning for People With ADRD

Launched by UNIVERSITY OF PITTSBURGH · Aug 19, 2024

Keywords

ClinConnect Summary

This clinical trial is exploring a new tool called the Dementia Advance Care Planning (AD ACP) Toolkit to help improve conversations about care goals for people living with dementia. The study will compare how well this toolkit works alongside standard care in helping patients and their primary care teams discuss important topics related to their health and future care plans. Over 18 months, the researchers will look at how often these discussions happen and how effective they are, as well as track things like identifying caregivers and completing advance care planning orders.

To participate, people living with dementia need to be 65 years or older and have a diagnosis of Alzheimer’s disease or related disorders. They must also have seen their primary care doctor in the past 18 months. Primary care team members involved must be doctors or advanced practice providers who regularly care for older adults at specific clinics. If eligible, participants can expect to engage in conversations about their health, preferences, and care planning, which can help ensure their wishes are respected as their condition progresses. This study aims to create better care experiences for patients living with dementia and their families.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• Primary care team member (PCTM) eligibility:
• • Must be an MD/APP, employed at a primary care clinic within UNC HEALTH clinics with ≥60 PLwD encounters per year, who sees older adult patients, along with their associated nurses and social workers.
• • Eligibility for training with AD ACP Toolkit will include the above and the provision of care at an intervention clinic.
• • For Aim 3, only the trained intervention site primary care team members will be eligible for the implementation surveys or the interviews.
• PLwD eligibility:
• • Must be a PLwD age 65 years or older seen by either the intervention or control sites' primary care teams' MD/APP in the 18-month intervention window for Aim 1.
• • PLwD will be eligible only after we confirm the presence of the AD/ADRD diagnosis.
• • All PLwD with a ≥50% 5-year all-cause mortality risk seen by the PCTM MD/APP over the 18-month intervention period will be eligible for the healthcare utilization analyses in Aim 2.
• Exclusion Criteria:
• Primary care team member exclusion criteria:
• • We will exclude primary care team members who do not care for older adults (e.g. pediatricians or lactation nurses), are employed at geriatric specialty or dementia specialty clinics, or are without a primary care panel (e.g., only urgent care).
• PLwD exclusion criteria:
• • Patients will be excluded if they have not been seen in the past 18 months by their primary care team, or if they do not have a diagnosis of ADRD.