Indiana University Dementia Screening Trial: The IU CHOICE Study

印第安纳大学痴呆症筛查试验：IU CHOICE 研究

基本信息

批准号：
8529431
负责人：
MALAZ BOUSTANI
金额：
$ 50.93万
依托单位：
INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-08-15 至 2017-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8529431
关键词：
Advance Care Planning Advisory Committees Advocate Alzheimer&apos s Disease American Anxiety Anxiety Disorders Behavioral Caregivers Caring Clinic Clinical Trials Cognitive Control Groups Counseling Coupled Data Dementia Diagnosis Disease Early Diagnosis Early identification Early treatment Elderly Equipment and supply inventories Future Healthcare Healthcare Systems Indiana Influentials Institute of Medicine (U.S.)Institutes Intervention Lead Literature Measures Medicare Memory impairment Mental Depression Modeling Moods Patient Care Patients Performance Phase Population Heterogeneity Prevention Preventive Primary Health Care Procedures Process Protocols documentation Questionnaires Randomized Randomized Controlled Trials Relative (related person)Reporting Research Research Activity Research Design Research Personnel Resources Services Source Symptoms Syndrome Testing United States United States Centers for Medicare and Medicaid Services Universities Visit aged beneficiary biopsychosocial chronic care model collaborative care control trial cost depressive symptoms evidence base functional disability health care service utilization improved interest neuropsychiatry pressure primary care setting primary outcome programs psychologic public health relevance screening systematic review therapeutic target tool treatment as usual

项目摘要

DESCRIPTION (provided by applicant): The United States Preventive Services Task Force (USPSTF) found no clinical trial that evaluated the efficacy of dementia screening in primary care. Pressures to institute screening of unproved benefit could divert much needed resources from health care systems and have an overall negative impact on care for patients with dementia and other illnesses, ultimately reducing current opportunities for dementia recognition. Using the framework of the chronic care model and evidence-based, comprehensive biopsychosocial dementia care protocols, our investigators developed and conducted a randomized controlled trial of a Collaborative Dementia Care Management program and found that such a program improves the behavioral and psychological symptoms related to dementia care and reduced the burden of dementia relative to usual care. Study Design: A two-phase randomized controlled dementia screening trial among 4,000 Americans aged 75 and older attending urban primary care clinics in Indianapolis, Indiana. Intervention: A dementia screening procedure followed by a Collaborative Dementia Care program. Controls: The study will have two control groups: "No Screening" and "Screening Only" groups. Primary Outcome of Potential Benefits: Behavioral and psychological symptoms related to dementia as measured by the Neuropsychiatric Inventory (NPI) at 18 months of randomization. Primary Outcome for Potential Harms: Mood and anxiety symptoms as measured by the PHQ-9 and GAD-7 at 18 months of randomization. Impact: The results of this study will help guide the United States Preventive Services Task Force in the decision to recommend for or against routine screening for dementia in primary care. In addition, the data generated by our proposed study could be used to model the impact of future pharmacological therapeutics targeting dementia but requiring early recognition of the syndrome as can occur if screening is done routinely among elders.

描述（由申请人提供）：美国预防服务工作组（USPSTF）发现没有临床试验评估痴呆症在初级保健中的疗效。筛查未经证实的福利的压力可能会从医疗保健系统中转移急需的资源，并对痴呆症和其他疾病患者的护理产生总体负面影响，最终减少了当前的痴呆症识别机会。我们的研究人员使用慢性护理模型和基于证据的综合生物心理社会痴呆症护理方案的框架，开发并进行了一项随机对照试验，对协作性痴呆症护理管理计划进行了随机对照试验，并发现此类计划改善了与痴呆症护理相关的行为和心理症状，并减轻了与经常护理相对于痴呆症的负担。研究设计：在印第安纳州印第安纳波利斯市的75岁及以上的4000名及以上的美国人，一项两相的随机对照痴呆症筛查试验。干预：痴呆症筛查程序，然后是协作痴呆症护理计划。对照：该研究将有两个对照组：“不筛查”和“仅筛选”组。潜在益处的主要结果：与痴呆症相关的行为和心理症状，如神经精神库存（NPI）在18个月的随机分组时所测量的。潜在危害的主要结果：PHQ-9和GAD-7在18个月的随机分组中测量的情绪和焦虑症状。影响：这项研究的结果将有助于指导美国预防服务工作组，决定推荐或反对初级保健痴呆症的常规筛查。此外，我们所提出的研究产生的数据可用于模拟未来药理治疗剂的靶向痴呆症的影响，但需要对综合征的早期认识，如果在长老中进行筛查，可能会发生。