Improving Dementia Care in Primary Practice

NCT07526480 — Not applicable, Not yet recruiting, 80 participants, Thomas Jefferson University

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RegistryNCT07526480, acronym IDC
StatusNot yet recruiting
PhaseNot applicable
Study typeInterventional; randomized, parallel, masking: none, screening
Enrollment80 (Estimated)
SponsorThomas Jefferson University (Other); collaborators: Independence Blue Cross
ConditionsAlzheimer Disease (AD), Mild Cognitive Impairment (MCI), Dementia
InterventionsImproving Dementia Care, Enhanced Usual Care (Other)
Datesstart 2026-05-04 (estimated), primary completion 2027-05-03 (estimated), completion 2027-05-03 (estimated), first posted 2026-04-13, last updated 2026-04-17

Related Papers Related Patents Related Grants Related Experts
All trials for Alzheimer Disease (AD) All trials for Mild Cognitive Impairment (MCI) All trials of Improving Dementia Care All trials of Enhanced Usual Care

-Summary

This clinical trial will evaluate a multi-level scalable intervention called Improving Dementia Care (IDC). The investigators hypothesize that IDC will increase dementia detection in patients with impaired cognition more than the control condition, Enhanced Usual Care (EUC), over 6 months.

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+Detailed description

This pilot RCT (N = 80) will evaluate the feasibility and effectiveness of a new multi-level intervention-Improving Dementia Care (IDC)-which aims to increase detection of Alzheimer disease (AD) in older primary care patients with impaired cognition. In IDC, investigators will screen older primary care patients for subjective cognitive concerns and objective cognitive impairment on the Telephone Interview for Cognitive Status (TICS). To eligible patients, the research team will deliver AD Education and Personalized Decision Counseling-eliciting values and goals to reach informed, preference-based decisions on whether to have an AD evaluation. In IDC, investigators will also send to primary care physicians (PCPs) the TICS results and a smart order set (i.e., orders for AD-relevant lab and neuroimaging) via the electronic health record (EHR). The research team posits that IDC-a patient-level and PCP-level intervention-will increase AD detection more than Enhanced Usual Care (EUC), which is usual care enhanced with sending the TICS results and smart order set to the PCPs of controls-solely a PCP-level intervention. At 6 months, investigators will compare IDC's vs. EUC's effectiveness to increase rates of: 1) Incident cognitive diagnoses (e.g., Mild Cognitive Impairment, AD); 2) Orders for AD-relevant lab and neuroimaging studies, 3) Completed AD-relevant lab and neuroimaging studies; 4) Prescribed AD medications; and 5) Referrals to AD specialists, masked to treatment assignment.

+Arms and interventions

ArmTypeInterventionsDescription
Improving Dementia Care (IDC)ExperimentalOther: Improving Dementia CareDuring a phone session, participants receive ADRD Education and Personalized Decision Counseling, which consists of eliciting values and goals to reach informed, preference-based decisions on whether to have an ADRD evaluation. Participants' primary care physicians are sent cognitive screening results and a smart order set (i.e., orders for ADRD-relevant lab and neuroimaging) via the electronic health record (EHR).
Enhanced Usual Care (EUC)Active comparatorOther: Enhanced Usual CareUsual care enhanced with notices sent to participants' primary care physicians with cognitive screening results and a smart order set (i.e., orders for ADRD-relevant lab and neuroimaging) via the electronic health record (EHR).
  • Improving Dementia Care (Other), also known as IDC: During a phone session, participants receive ADRD Education and Personalized Decision Counseling, which consists of eliciting values and goals to reach informed, preference-based decisions on whether to have an ADRD evaluation. Participants' primary care physicians are sent cognitive screening results and a smart order set (i.e., orders for ADRD-relevant lab and neuroimaging) via the electronic health record (EHR).
  • Enhanced Usual Care (Other), also known as EUC: Usual care enhanced with notices sent to participants' primary care physicians with cognitive screening results and a smart order set (i.e., orders for ADRD-relevant lab and neuroimaging) via the electronic health record (EHR).

+Outcome measures

Primary outcomes

  • Incident cognitive diagnoses. [6 months]: Chart reviews will identify the number of patients with a new cognitive diagnosis in each arm.

Secondary outcomes

  • Orders for Alzheimer's disease-relevant lab and neuroimaging [6 months]: Chart reviews will identify the number of patients with a new relevant lab and imaging tests.
  • Prescribed Alzheimer's disease (AD) medications. [6 months]: Chart reviews will identify the number of patients with a new AD medications.
  • Referrals to Alzheimer's disease specialists [6 months]: Chart reviews will identify the number of patients with relevant referrals.
  • Completed AD-relevant lab and neuroimaging studies [6 months]: Chart reviews will identify the number of patients with completed orders.

+Eligibility

Sex: All, ages: 66 Years to any, accepts healthy volunteers

Inclusion Criteria:

* No previous diagnosis of mild cognitive impairment (MCI) or Alzheimer's disease (AD).
* Have a scheduled PCP visit in the next 4-6 weeks
* Have subjective cognitive impairment
* Score ≥ 26 on the Telephone Interview for Cognitive Status (TICS)

Exclusion Criteria:

* EHR evidence or previous cognitive evaluations, diagnosis of MCI or AD, or use of AD medications
* TICS score of ≤ 11.00
* Inability to provide informed consent

+Investigators