The Hospice Advanced dementia Symptom Management and Quality of Life Trial (HAS-QOL)
临终关怀晚期痴呆症症状管理和生活质量试验 (HAS-QOL)
基本信息
- 批准号:10248435
- 负责人:
- 金额:$ 113.28万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2019
- 资助国家:美国
- 起止时间:2019-09-01 至 2023-08-31
- 项目状态:已结题
- 来源:
- 关键词:AdoptionAdvanced Malignant NeoplasmAffectAgeAggressive behaviorAgitationAlzheimer&aposs DiseaseAnalgesicsAntipsychotic AgentsAreaAwardBackBehavioral SymptomsCaregiver supportCaregiversCaringCessation of lifeCommunitiesDementiaDementia caregiversDiagnosisDiscipline of NursingDiseaseEffectivenessEnsureEvidence based interventionEvidence based practiceExtramural ActivitiesFeedbackGeriatric NursingGoalsHealth systemHealthcareHomeHome Care ServicesHome Health AidesHome Health Care AgenciesHospice CareHospice ProgramsHospital MortalityHourIncidenceInfrastructureInpatientsInstitutesInstitutionalizationInterventionLength of StayLevel of EvidenceLifeLong-Term CareMeasurementMeasuresMental DepressionModelingNursing HomesOutcomePainPain managementPatientsPersonsPharmacologyPhasePopulationPragmatic clinical trialProgram EffectivenessProtocols documentationPsychosocial Assessment and CarePublic HealthQuality of CareQuality of lifeRandomizedReproducibilityResortSafetySerious Adverse EventSiteSleep disturbancesStatistical MethodsSymptomsSystemTestingTrainingVisitWorkadvanced dementiabaseburden of illnessburnoutcare systemsclinical carecomorbiditydata managementend of lifeend of life careevidence basefallshospice environmenthuman datahuman subjectimplementation fidelityimplementation interventionimprovedinnovationinpatient serviceintervention refinementmemberpatient home carepragmatic trialprimary caregiverprimary outcomeprogramspsychological symptomrespite caresatisfactionsecondary outcomesymptom managementtrial designworking group
项目摘要
As the population ages, the incidence rate of Alzheimer's Disease and Related Disorders (dementia) is expected
to triple. The National Alzheimer's Plan recognizes that while the number of persons with dementia (PWD) is
increasing substantially, the healthcare and long term care systems are unprepared to provide high quality,
effective and efficient care to the PWD and their caregivers. PWD often have many behavioral and psychological
symptoms of dementia (BPSD) including agitation, depression and sleep disturbances, that affect both the quality
of life of the PWD and the caregiver. Unfortunately, due to a lack of programs to insert evidence-based care into
the community, and hospice system specifically, PWD receive inappropriate and even harmful care. We have
developed the Dementia Symptom Management at Home (DSM-H) Program to implement dementia friendly
care for PWD and their caregivers in the community. Initially developed for use in home healthcare, we have
modified the program for use in hospice. The DSM-H Hospice Edition is a systems level change program that
includes workforce training, and agency level workflow changes. Through the Hospice Advanced Dementia
Symptom Management and Quality of Life (HAS-QOL) Trial, in the R61 phase, we will: Aim 1: Establish the
infrastructure necessary for implementing a pragmatic clinical trial of the DSM-H Hospice Edition. Aim 2: Further
tailor the DSM-H program specifically for hospice IDT members caring for PWD receiving end of life care and
adapt for wide-scale implementation in hospice. Aim 3: Pilot test the complete protocol in 2 hospice agencies
and refine the protocol further based on feedback from the pilot agencies. Following successful completion of
the milestones at the end of the R61 year surrounding feasibility, applicability, and fidelity, we will move forward
with the R33 phase where, we will: Aim 4: Conduct a pragmatic, randomized stepped wedged cluster RCT of
the Dementia Symptom Management at Home Program Hospice Edition with advanced dementia patients living
at home (N=30/agency per month) in 25 hospice agencies comparing antipsychotics (Primary Outcome) and
analgesic use (Secondary Outcome) before and after implementation. Aim 5: Compare the rates of hospice
continuous, inpatient and temporary respite care hours provided, and rate of permanent institutionalization in a
nursing home prior to and after implementation (Secondary Outcomes). Aim 6: Assess care satisfaction of the
bereaved primary caregiver. (Secondary Outcome) Exploratory Aim 7: Assess the spillover effects of the DSM-
H on hospice patients who are identified as having dementia as a comorbidity, and advanced dementia patients
who are living in nursing homes. This is an innovative proposal as it would be the first large-scale pragmatic trial
in a hospice focused on PWD and their caregivers, and has a strong scientific premise, rigor and potential for
reproducibility. Following completion of the trial, should the findings show that the DSM-H Hospice Edition is
effective in improving quality of care and has high adoption and implementation fidelity, we will develop a
technical assistance center through the Hartford Institute for Geriatric Nursing to disseminate the model of care.
随着人口的老龄化,阿尔茨海默病和相关疾病(痴呆症)的发病率是预期的
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)
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Abraham Aizer Brody其他文献
Abraham Aizer Brody的其他文献
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{{ truncateString('Abraham Aizer Brody', 18)}}的其他基金
ED-LEAD: Emergency Departments LEading the transformation of Alzheimer's and Dementia care
ED-LEAD:急诊科引领阿尔茨海默病和痴呆症护理的变革
- 批准号:
10709334 - 财政年份:2023
- 资助金额:
$ 113.28万 - 项目类别:
Leveraging Electronic Health Records for Reducing Dementia Screening Disparities in Diverse Communities
利用电子健康记录减少不同社区的痴呆症筛查差异
- 批准号:
10525774 - 财政年份:2023
- 资助金额:
$ 113.28万 - 项目类别:
The Hospice Advanced dementia Symptom Management and Quality of Life Trial (HAS-QOL)
临终关怀晚期痴呆症症状管理和生活质量试验 (HAS-QOL)
- 批准号:
10018613 - 财政年份:2019
- 资助金额:
$ 113.28万 - 项目类别:
The Hospice Advanced dementia Symptom Management and Quality of Life Trial (HAS-QOL)
临终关怀晚期痴呆症症状管理和生活质量试验 (HAS-QOL)
- 批准号:
10474598 - 财政年份:2019
- 资助金额:
$ 113.28万 - 项目类别:
The Hospice Advanced dementia Symptom Management and Quality of Life Trial (HAS-QOL)
临终关怀晚期痴呆症症状管理和生活质量试验 (HAS-QOL)
- 批准号:
10007090 - 财政年份:2019
- 资助金额:
$ 113.28万 - 项目类别:
P20 Exploratory Center for Precision Health in Diverse Populations
P20多元化人群精准健康探索中心
- 批准号:
10175058 - 财政年份:2018
- 资助金额:
$ 113.28万 - 项目类别: