The Care Ecosystem: Navigating patients and caregivers through stages of dementia care
The Care Ecosystem: Navigating patients and caregivers through stages of dementia care
批准号:
10158375
负责人:
Katherine Laurel Possin
金额:
$109.24万
依托单位国家:
美国
项目类别:
财政年份:
2017
资助国家:
美国
项目状态:
已结题
起止时间:
2017-09-30 至 2023-05-31
关键词:
AwardBehaviorBehavioral SymptomsCaliforniaCaregiver BurdenCaregiver supportCaregiversCaringCessation of lifeCharacteristicsClinicalCommunicationCommunitiesComplementConsultationsContinuity of Patient CareDay CareDecision MakingDeliriumDementiaDementia caregiversDimensionsDiseaseEconomicsEcosystemElementsEnvironmentFamilyFundingHealthHealth Care CostsHealth PolicyHealth systemHealthcareHealthcare SystemsHospitalizationHouseholdIatrogenesisIncomeIndividualInternetIowaLearningLegalLocalesLong-Term CareLong-Term EffectsLongitudinal StudiesMeasurementMediationMedicalMedicare/MedicaidMental DepressionModelingNebraskaNursesNursing HomesOnline SystemsOutcomePatientsPersonsPharmaceutical PreparationsPharmacistsPoliciesPopulation HeterogeneityPrimary Health CareQuality of lifeRandomizedRandomized Controlled TrialsReportingResourcesRiskRuralSamplingSan FranciscoSelf EfficacySeveritiesSocial Well-BeingSocial WorkSocial WorkersSocial isolationSocietiesSupervisionSymptomsSystemTelephoneTimeTrainingbeneficiarycare burdencare costscare deliverycare outcomescare systemscaregiver depressioncaregiver educationcohortcostdementia caredesigneconomic outcomeend of lifeend of life careethnic minority populationevidence basefallshospice environmentimprovedinnovationmedical complicationmedical specialtiesmultiple chronic conditionspatient orientedpatient populationphysical conditioningprematureprogramspsychosocialrural residencesatisfactionsocioeconomicssuburbtreatment as usualtreatment effecttreatment responsetrend
中文摘要
项目总结/文摘
英文摘要
PROJECT SUMMARY/ABSTRACT
Dementia causes substantial burdens for patients, their caregivers, and health care systems. Recent and
potential changes in health care policy indicate a shift towards reimbursement models that could sustain
evidence-based dementia care. Currently, there is a wide gap between best practice in dementia and real-
world care delivery. Scalable, effective, and patient-centered dementia care models that are aligned with
trends in reimbursement reform are needed now. The Care Ecosystem is a dementia support program that
combines elements of effective programs into a scalable model that could be successful in the new policy
environment. Care is delivered via the phone and web by unlicensed Care Team Navigators, who are trained
and supervised by a nurse, social worker, and pharmacist. Proactive care modules focus on caregiver support
and education, medication consultation, support around medical, financial, and legal decisions, and behavior
management. We are evaluating the short-term impact of the Care Ecosystem on psychosocial and economic
outcomes in a randomized controlled trial, funded by the Centers for Medicare and Medicaid Innovation.
Patients and caregivers from rural and urban locales, with a range of socioeconomic characteristics, and
cohorts of Spanish and Cantonese speaking persons are included. Short-term (6 month) results suggest
benefit, and we expect that the greatest impact of our care program will be realized in the long term across all
stages of dementia. This proposed project would continue the care and measurement in our existing cohort to
determine the 5-year treatment effects and to characterize the patients and caregivers most likely to benefit. In
Aim 1, we will evaluate the Care Ecosystem's effects on patient quality of life, time to nursing home placement,
cost of care, and caregiver burden, depression, and health across the disease trajectory. In Aim 2, we will
determine the differential treatment effects by rural/urban locale, household income, ethnic minority status, and
by severity of behavioral symptoms, caregiver burden, and social isolation. In Aim 3, we will determine the
effects of Care Ecosystem on end of life care among patients who die. By clarifying the impacts of this scalable
dementia care program, our project would provide important guidance as health systems determine what
dementia care services to provide and to which beneficiaries. In addition, results would provide a framework for
caring for a diverse population of patients and caregivers across the care continuum.
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DOI:
10.1111/jgs.18297
发表时间:
2023-07
期刊:
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
影响因子:
6.3
作者:
[Sideman, Alissa Bernstein, Merrilees, Jennifer, Dulaney, Sarah, Kiekhofer, Rachel, Braley, Tamara, Lee, Kirby, Chiong, Winston, Miller, Bruce, Bonasera, Stephen J., Possin, Katherine L.]
通讯作者:
Possin, Katherine L.
DOI:
10.1186/s12888-022-03809-2
发表时间:
2022-02-28
期刊:
BMC psychiatry
影响因子:
4.4
作者:
[LaHue SC, Escueta DP, Guterman EL, Patel K, Harrison KL, Boscardin WJ, Douglas VC, Newman JC]
通讯作者:
Newman JC
DOI:
10.1001/jamanetworkopen.2023.36030
发表时间:
2023-09-05
期刊:
JAMA NETWORK OPEN
影响因子:
13.8
作者:
[Sideman, Alissa Bernstein, Ma, Melissa, de Jesus, Alma Hernandez, Alagappan, Cecilia, Razon, Na'amah, Dohan, Daniel, Chodos, Anna, Al-Rousan, Tala, Alving, Loren I., Segal-Gidan, Freddi, Rosen, Howie, Rankin, Katherine P., Possin, Katherine L., Borson, Soo]
通讯作者:
Borson, Soo
DOI:
10.1080/10903127.2020.1817214
发表时间:
2021-09
期刊:
Prehospital emergency care
影响因子:
2.4
作者:
[Hart L, Sanford JK, Sporer KA, Kohn MA, Guterman EL]
通讯作者:
Guterman EL
Management of Status Epilepticus and Indications for Inpatient Electroencephalography Monitoring.
癫痫持续状态的管理和住院患者脑电图监测的适应症。
DOI:
10.1016/j.ncl.2021.08.001
发表时间:
2022
期刊:
Neurologic clinics
影响因子:
2.4
作者:
[Fan,JolineM, Singhal,NeelS, Guterman,ElanL]
通讯作者:
Guterman,ElanL
共 9 条
The Care Ecosystem Response to COVID-19: Accelerating Research on Dementia Care that Meets the Needs of Caregivers and Persons with Dementia during COVID-19
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批准号:10324344
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项目类别:
-
资助金额:$290.88万
-
财政年份:2022
-
负责人:Katherine Laurel Possin
-
依托单位:
The Care Ecosystem Response to COVID-19: Accelerating Research on Dementia Care that Meets the Needs of Caregivers and Persons with Dementia during COVID-19
-
批准号:10634511
-
项目类别:
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资助金额:$296.74万
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财政年份:2022
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负责人:Katherine Laurel Possin
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依托单位:
A Pragmatic Trial of the UCSF Brain Health Assessment for the Detection of Cognitive Impairment in Primary Care
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批准号:10524698
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项目类别:
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资助金额:$162.41万
-
财政年份:2022
-
负责人:Katherine Laurel Possin
-
依托单位:
A Pragmatic Trial of the UCSF Brain Health Assessment for the Detection of Cognitive Impairment in Primary Care
-
批准号:10705314
-
项目类别:
-
资助金额:$160.28万
-
财政年份:2022
-
负责人:Katherine Laurel Possin
-
依托单位:
PossinK, NIH, R01 Supplement P0568851 4/4/2023
-
批准号:10820892
-
项目类别:
-
资助金额:$150.96万
-
财政年份:2022
-
负责人:Katherine Laurel Possin
-
依托单位:
Reimagining Precision Medicine Approaches to AD Diagnosis
-
批准号:10604257
-
项目类别:
-
资助金额:$96.41万
-
财政年份:2021
-
负责人:Katherine Laurel Possin
-
依托单位:
Reimagining Precision Medicine Approaches to AD Diagnosis
-
批准号:10382435
-
项目类别:
-
资助金额:$96.4万
-
财政年份:2021
-
负责人:Katherine Laurel Possin
-
依托单位:
Reimagining Precision Medicine Approaches to AD Diagnosis
-
批准号:10211331
-
项目类别:
-
资助金额:$97.94万
-
财政年份:2021
-
负责人:Katherine Laurel Possin
-
依托单位:
The UCSF Brain Health Assessment for the Detection of Cognitive Impairment Among Diverse Populations in Primary Care
-
批准号:10100827
-
项目类别:
-
资助金额:$7.28万
-
财政年份:2020
-
负责人:Katherine Laurel Possin
-
依托单位:
The UCSF Brain Health Assessment for the Detection of Cognitive Impairment Among Diverse Populations in Primary Care
-
批准号:10260511
-
项目类别:
-
资助金额:$152.04万
-
财政年份:2017
-
负责人:Katherine Laurel Possin
-
依托单位:
The UCSF Brain Health Assessment for the Detection of Cognitive Impairment Among Diverse Populations in Primary Care
-
批准号:9766416
-
项目类别:
-
资助金额:$155.04万
-
财政年份:2017
-
负责人:Katherine Laurel Possin
-
依托单位:
The UCSF Brain Health Assessment for the Detection of Cognitive Impairment Among Diverse Populations in Primary Care
-
批准号:10472875
-
项目类别:
-
资助金额:$8.05万
-
财政年份:2017
-
负责人:Katherine Laurel Possin
-
依托单位:
Mechanisms of Spatial Cognitive Impairment in Neurodegenerative Disease
-
批准号:8288083
-
项目类别:
-
资助金额:$13.93万
-
财政年份:2011
-
负责人:Katherine Laurel Possin
-
依托单位:
Mechanisms of Spatial Cognitive Impairment in Neurodegenerative Disease
-
批准号:8683052
-
项目类别:
-
资助金额:$13.93万
-
财政年份:2011
-
负责人:Katherine Laurel Possin
-
依托单位:
Mechanisms of Spatial Cognitive Impairment in Neurodegenerative Disease
-
批准号:8493963
-
项目类别:
-
资助金额:$13.93万
-
财政年份:2011
-
负责人:Katherine Laurel Possin
-
依托单位:
Mechanisms of Spatial Cognitive Impairment in Neurodegenerative Disease
-
批准号:8111039
-
项目类别:
-
资助金额:$13.93万
-
财政年份:2011
-
负责人:Katherine Laurel Possin
-
依托单位:
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