Care4AD: A Comprehensive Care Coordination and Management Platform for Alzheimer Disease and Related Dementias

摘要 对痴呆症患者的护理需要持续有效地管理和协调护理的交付 在照顾者和家庭成员之间。强大的技术驱动型解决方案，用于护理管理和 协调可以显著减轻护理负担，提高患者的生活质量 阿尔茨海默病(AD)。已经进行了一些尝试，以使用技术来支持护理协调，但 没有一个综合系统来支持自我护理、协助照顾者进行护理协调和促进 病人护理团队内的信息共享。为了回应这一需求，BioSensics与 贝勒医学院提议开发一个名为Care4AD™的综合护理平台。这个 Care4AD平台将允许照顾者计划照看任务，监控身体活动和 日常生活(ADL)，并促进ADL的及时完成(例如，服药、定时如厕、补充水分 和用餐，以及出席预定的约会)通过视觉和语音提醒。 Care4AD将由四项技术组成，这些技术协同工作，实现有效的护理协调。这个 照顾者将使用Care4AD应用程序来协调护理、查看体力活动和ADL信息，以及 日程提醒。Care4AD平板电脑在患者家中充当一个信息亭，显示预定的活动 和提醒，它还支持音频提醒和语音识别。Care4AD标签是一系列 无线传感器，将连接到家庭内的各种感兴趣的对象，以便于监控 日常生活的工具性活动。最后，Care4AD传感器是一种可穿戴传感器(基于现有的 来自BioSensics的商业可用技术)，其监控体力活动和ADL，从 标签，并将数据传输到Care4AD平板电脑，该平板电脑充当所有收集数据的数据网关 从传感器和标签上。 BioSensics拥有成功完成该项目所需的经验，已开发和 将一种基于传感器的老年人远程监控平台PAMSys™商业化。对于这个项目， 我们已经进行了三项初步研究，使用PAMSys监测患有疾病的个人的体力活动 认知障碍。此外，BioSensics已经开发了Care4AD标签的原型，它将 在这个项目中得到进一步的完善。在第一阶段，我们将开发Care4AD平台的原型并进行 与利益相关者面谈，以评估Care4AD的可行性和可接受性，并收集将 用来完善平台的。在第二阶段，我们将完成Care4AD的开发，并纳入反馈 从I期开始，进行随机对照临床研究，以评估是否使用Care4AD平台 减轻护理的负担和压力，提高对预定ADL的依从性，并改善身体状况 患者的功能和生活质量。

ABSTRACT Care for persons with dementia requires constant and effective management and coordination of delivery of care between caregivers and family members. A robust, technology-driven solution for care management and coordination could significantly reduce the burden of caregiving and improve quality of life for patients with Alzheimer’s disease (AD). A few attempts have been made to use technology to support care coordination, but there is no integrated system to support self-care, assist caregivers with care coordination, and facilitate information sharing within a patient's caregiving team. In response to this need, BioSensics, in collaboration with Baylor College of Medicine (BCM), proposes to develop a comprehensive care platform called Care4AD™. The Care4AD platform will allow caregivers to schedule caregiving tasks, monitor physical activity and activities of daily living (ADL), and facilitate timely completion of ADLs (e.g., taking medication, scheduled toileting, hydration and meals, and attendance at scheduled appointments) through visual and voice reminders. Care4AD will consist of four technologies that work in tandem to enable effective care coordination. The Care4AD app will be used by caregivers to coordinate care, view physical activity and ADL information, and schedule reminders. The Care4AD tablet serves as a kiosk in the patient’s home to show scheduled activities and reminders, and it also supports audio reminders and voice recognition. Care4AD tags are a series of wireless sensors that will be attached to various objects of interest within the home to facilitate the monitoring of instrumental activities of daily living. Finally, the Care4AD sensor is a wearable sensor (based on existing commercially available technology from BioSensics) that monitors physical activity and ADLs, collects data from the tags, and transfers data to the Care4AD tablet, which serves as a data gateway for all the data collected from the sensor and tags. BioSensics has the requisite experience to successfully complete this project having developed and commercialized a sensor-based remote monitoring platform for older adults called PAMSys™. For this project, we have conducted three preliminary studies using PAMSys to monitor physical activity in individuals with cognitive impairment. In addition, BioSensics has already developed a prototype of the Care4AD tag, which will be further refined in this project. In Phase I, we will develop a prototype of the Care4AD platform and carry out stakeholder interviews to assess the feasibility and acceptability of Care4AD and gather feedback that will be used to improve the platform. In Phase II, we will complete the development of Care4AD, incorporating feedback from Phase I, and carry out a randomized controlled clinical study to evaluate if using the Care4AD platform reduces the burden and stress of caregiving, increases adherence to scheduled ADLs, and improves physical function and quality of life of patients.