Improving Primary Care Clinicians’ Advance Care Planning for Persons Living with Alzheimer’s Disease and Related Dementias

改善初级保健临床医生对阿尔茨海默病和相关痴呆症患者的预先护理计划

基本信息

项目摘要

PROJECT SUMMARY/ABSTRACT Advance care planning (ACP) is difficult for all older adults, but dementia makes ACP even more difficult. Alzheimer's disease and Alzheimer's disease related neurodegenerative dementias (AD/ADRD) are incurable, progressive and terminal diseases with unparalleled impact on the US healthcare system, patients and families. Over 5 million Americans live with AD/ADRD, and people with AD/ADRD lose decision-making capacity years in advance of critical and serious medical illness. Clinicians must discern when and how people with AD/ADRD can express valid treatment preferences at all stages of AD/ADRD. Additionally, significant disparities exist for people with AD/ADRD in minority communities. Most people with AD/ADRD are managed by their primary care clinics whose primary care teams receive little education and training on dementia management, and no attention to dementia-specific ACP communication needs. Primary care teams, including physicians, advance practice providers, nurses and social workers, are well-positioned to empower people living with AD/ADRD (PLwD) and their families in ACP, especially minority communities, yet lack critical dementia-specific communication skills. Evidence-based ACP interventions for PLwD are rare, and no prior clinical trial addresses AD/ADRD ACP in primary care with a focus on health disparities in Black PLwD. Our experienced investigative team has demonstrated feasibility and preliminary efficacy of an AD ACP practice improvement toolkit (AD ACP toolkit) for primary care teams. We will test whether our AD ACP toolkit will enable primary care teams to better conduct GOC discussions more efficiently and thus increase the number of GOC discussions held as compared to controls. We will deliver the AD ACP toolkit to 10 intervention primary care clinics and usual care to 10 control clinics with large Black populations within a large integrated health care system. Our first aim is to conduct a trial comparing the AD ACP Toolkit to usual care on goals of care discussions and other ACP measures (N=600). We will conduct stratified analyses for Black PLwD. The second aim is to examine the 18-month healthcare utilization outcomes for all PLwD served by intervention vs control clinics and conduct secondary analyses for Black PLwD. Lastly, we will assess implementation via surveys in the intervention clinics (N=120) followed by interviews (N=60) to understand any disparities in ACP for Black PLwD. This project addresses National Institute on Aging's mission to improve care for older adults with AD/ADRD in primary care. This work will improve how to incorporate ACP approaches for aging-related conditions by primary care teams and may be adaptable to other outpatient specialties such as oncology or cardiology.
项目总结/文摘

项目成果

期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ monograph.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ sciAawards.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ conferencePapers.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ patent.updateTime }}

Christine E Kistler其他文献

Christine E Kistler的其他文献

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

{{ truncateString('Christine E Kistler', 18)}}的其他基金

Improving Primary Care Clinicians' Advance Care Planning for Alzheimer's Disease and Related Dementias
改善初级保健临床医生针对阿尔茨海默病和相关痴呆症的预先护理计划
  • 批准号:
    10738376
  • 财政年份:
    2023
  • 资助金额:
    $ 38万
  • 项目类别:
Nurse and Physician Decision-making for Suspected Urinary Tract Infections in Nursing Homes: Potential Targets to Reduce Antibiotic Overuse
疗养院中疑似尿路感染的护士和医生决策:减少抗生素过度使用的潜在目标
  • 批准号:
    9077477
  • 财政年份:
    2016
  • 资助金额:
    $ 38万
  • 项目类别:

相似海外基金

EAGER: Toward a Decentralized Cross-administrator Zone Management System: Policy and Technology
EAGER:走向去中心化的跨管理员区域管理系统:政策和技术
  • 批准号:
    2331936
  • 财政年份:
    2023
  • 资助金额:
    $ 38万
  • 项目类别:
    Standard Grant
COLLABORATIVE RESEARCH: Social Influence in Eyewitness Identification Procedures: Do Blind Administrator Behaviors Magnify the Effects of Suspect Bias?
合作研究:目击者识别程序中的社会影响:盲目的管理员行为是否会放大嫌疑人偏见的影响?
  • 批准号:
    2043230
  • 财政年份:
    2021
  • 资助金额:
    $ 38万
  • 项目类别:
    Continuing Grant
COLLABORATIVE RESEARCH: Social Influence in Eyewitness Identification Procedures: Do Blind Administrator Behaviors Magnify the Effects of Suspect Bias?
合作研究:目击者识别程序中的社会影响:盲目的管理员行为是否会放大嫌疑人偏见的影响?
  • 批准号:
    2043334
  • 财政年份:
    2021
  • 资助金额:
    $ 38万
  • 项目类别:
    Continuing Grant
Making of the base for patient safety management skill of visiting nurse administrator by the web conference system
利用网络会议系统构建出诊护士管理者患者安全管理技能基础
  • 批准号:
    19K10768
  • 财政年份:
    2019
  • 资助金额:
    $ 38万
  • 项目类别:
    Grant-in-Aid for Scientific Research (C)
Development of the nursing administrator training program to improve leadership behavior focused on emotional intelligence
制定护理管理人员培训计划,以改善以情商为重点的领导行为
  • 批准号:
    18K17464
  • 财政年份:
    2018
  • 资助金额:
    $ 38万
  • 项目类别:
    Grant-in-Aid for Early-Career Scientists
Automated Network Management that Dynamically Reflects Administrator Intent
动态反映管理员意图的自动化网络管理
  • 批准号:
    18K18038
  • 财政年份:
    2018
  • 资助金额:
    $ 38万
  • 项目类别:
    Grant-in-Aid for Early-Career Scientists
Administrator support perceived as useful for professional growth by novice psychiatric home-visit nursing staff
新手精神科家访护理人员认为管理员支持对专业成长有用
  • 批准号:
    17H07005
  • 财政年份:
    2017
  • 资助金额:
    $ 38万
  • 项目类别:
    Grant-in-Aid for Research Activity Start-up
The Facts and Problems on Management of Public Museums: Validation of Designated Administrator System
公共博物馆管理的事实与问题:指定管理员制度的验证
  • 批准号:
    17K01212
  • 财政年份:
    2017
  • 资助金额:
    $ 38万
  • 项目类别:
    Grant-in-Aid for Scientific Research (C)
A Study on Transformation of the School Administrator Preparation and Evaluation System in the United States
美国学校管理人员培养与评价体系转型研究
  • 批准号:
    26780449
  • 财政年份:
    2014
  • 资助金额:
    $ 38万
  • 项目类别:
    Grant-in-Aid for Young Scientists (B)
The Family Court's Supervision of Property Administrator
家庭法院对财产管理人的监督
  • 批准号:
    26380108
  • 财政年份:
    2014
  • 资助金额:
    $ 38万
  • 项目类别:
    Grant-in-Aid for Scientific Research (C)
{{ showInfoDetail.title }}

作者:{{ showInfoDetail.author }}

知道了