Caregiver Burnout
Conditions
Keywords
Caregiver, Older adult, Primary care, Screening
Brief summary
The goal of this project is to pilot test CHEC (Collaborative Healthcare Encounters with Caregivers) in primary care. CHEC is brief intervention with two components: 1) a checklist to identify the needs and concerns of unpaid/family caregivers who accompany older patients (aged 65+) to their primary care visits and 2) accompanying Tip Sheet for clinicians.
Interventions
BEHAVIORALCollaborative Healthcare Encounters with Caregivers (CHEC)
CHEC is a brief checklist designed to identify family caregivers' unmet needs and concerns.
BEHAVIORALUsual Care
Attendance at primary care appointments as usual.
Sponsors
National Institute on Aging (NIA)
Weill Medical College of Cornell University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SCREENING
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
21 Years to 89 Years
Healthy volunteers
Yes
Inclusion criteria
Patients * Age 65-89 * English speaking * Women and men * Of varying race/ethnicity * Accompanied to primary care visits at the Center on Aging by a family caregiver (family caregiver also consents to participating in this study) * Sufficient cognitive capacity to consent themselves or through a legal representative Caregivers * Age 21+ * English speaking * Women and men * Of varying race/ethnicity * Accompany an older adult to his or her primary care visits at the Center on Aging (Older adult also consents to participating in this study) * Cognitively intact (on basis of a 6-item cognitive screen) Clinicians * Age 21+ * Women and men * Of varying race/ethnicity * Treat patients at the Center on Aging
Exclusion criteria
* Patients, caregivers, and clinicians that do not meet the inclusion criteria. * Patients and caregivers who are deaf or have hearing impairments that limit their ability to answer telephone queries. * Caregivers who are visually impaired and cannot see well enough to read large print and complete paper-based surveys. * Patients and/or caregivers whose dyad counterpart does not consent to take part in the study (i.e., Patients gives consent and their caregiver does not).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The Number of Caregivers Who Complete the Checklist | Through study completion, up to 1 year | The number of caregivers who complete the checklist |
| Acceptable Length of CHEC, as Measured by the Number of Caregivers Who Report That the Checklist is an Acceptable Length | Post intervention, at 1 week | Acceptable length of CHEC, as measured by the number of caregivers who report that the checklist is an acceptable length |
| CHEC's Ease of Use, as Measured by the Number of Caregivers Who Report That the Checklist is Easy to Use | Post intervention, at 1 week | CHEC's ease of use, as measured by the number of caregivers who report that the checklist is easy to use |
| CHEC's Helpfulness in Identify Caregivers' Needs, as Measured by the Number of Caregivers Who Report That the Checklist is Helpful in Identifying Their Needs | Post intervention, at 1 week | CHEC's helpfulness in identify caregivers' needs, as measured by the number of caregivers who report that the checklist is helpful in identifying their needs |
| CHEC's Helpfulness in Starting a Conversation With Health Care Providers About Caregivers' Needs, as Measured by the Number of Caregivers Who Report That the Checklist is Helpful in Starting a Conversation With Providers About Their Needs | Post intervention, at 1 week | CHEC's helpfulness in starting a conversation with health care providers about caregivers' needs, as measured by the number of caregivers who report that the checklist is helpful in starting a conversation with providers about their needs |
| Desire to Continue Use, as Measured by the Number Caregivers Who Report That They Desire to Continue Using the Checklist in the Future | Post intervention, at 1 week | Desire to continue use, as measured by the number caregivers who report that they desire to continue using the checklist in the future |
| Discussion of Caregivers' Needs, as Measured by the Number of Completed Checklists That Result in a Conversation With Providers About Caregiver Needs/Concerns | Post intervention, at 1 week | Discussion of caregivers' needs, as measured by the number of completed checklists that result in a conversation with providers about caregiver needs/concerns |
Countries
United States
Participant flow
Recruitment details
The trial was conducted at an academic affiliated geriatrics practice in New York City.
Pre-assignment details
Participants included primary care physicians, patients, and their accompanying family caregivers. Physicians were were randomized 1:1 to CHEC or usual care using a computer-assisted algorithm to ensure unbiased allocation. Patient-caregiver dyads of participating physicians were allocated to CHEC or usual care based on the randomization of their assigned physician. The counts below for the CHEC and Usual Care arms include patients and caregivers.
Participants by arm
| Arm | Count |
|---|---|
| Caregiver Checklist (CHEC): Caregivers CHEC is composed of two elements: 1) a checklist to identify the needs and concerns of unpaid/family caregivers who accompany older adults (aged 65+) to their primary care visits and 2) Tip Sheet for clinicians.
Collaborative Healthcare Encounters with Caregivers (CHEC): CHEC is a brief checklist designed to identify family caregivers' unmet needs and concerns. | 29 |
| Caregiver Checklist (CHEC): Patient CHEC is composed of two elements: 1) a checklist to identify the needs and concerns of unpaid/family caregivers who accompany older adults (aged 65+) to their primary care visits and 2) Tip Sheet for clinicians.
Collaborative Healthcare Encounters with Caregivers (CHEC): CHEC is a brief checklist designed to identify family caregivers' unmet needs and concerns. | 29 |
| Usual Care: Caregiver Attendance at primary care appointments as usual.
Usual Care: Attendance at primary care appointments as usual. | 24 |
| Usual Care: Patient Attendance at primary care appointments as usual.
Usual Care: Attendance at primary care appointments as usual. | 24 |
| Clinicians Participating physicians of the patients | 7 |
| Total | 113 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Overall Study | Lost to Follow-up | 6 | 2 | 0 |
Baseline characteristics
| Characteristic | Caregiver Checklist (CHEC): Caregivers | Total | Usual Care: Patient | Usual Care: Caregiver | Caregiver Checklist (CHEC): Patient | Clinicians |
|---|---|---|---|---|---|---|
| Age, Continuous | 65.4 years STANDARD_DEVIATION 11.4 | 75.3 years STANDARD_DEVIATION 15 | 86.2 years STANDARD_DEVIATION 5.4 | 61.7 years STANDARD_DEVIATION 13 | 86.9 years STANDARD_DEVIATION 8.1 | — |
| Ethnicity (NIH/OMB) Hispanic or Latino | 3 Participants | 7 Participants | 0 Participants | 2 Participants | 2 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 26 Participants | 97 Participants | 20 Participants | 21 Participants | 23 Participants | 7 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 9 Participants | 4 Participants | 1 Participants | 4 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 3 Participants | 8 Participants | 0 Participants | 0 Participants | 3 Participants | 2 Participants |
| Race (NIH/OMB) Black or African American | 2 Participants | 9 Participants | 3 Participants | 2 Participants | 2 Participants | 0 Participants |
| Race (NIH/OMB) More than one race | 3 Participants | 12 Participants | 3 Participants | 1 Participants | 5 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 1 Participants | 1 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 1 Participants | 5 Participants | 2 Participants | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) White | 19 Participants | 78 Participants | 16 Participants | 20 Participants | 18 Participants | 5 Participants |
| Region of Enrollment United States | 29 participants | 113 participants | 24 participants | 24 participants | 29 participants | 7 participants |
| Sex: Female, Male Female | 27 Participants | 78 Participants | 18 Participants | 15 Participants | 14 Participants | 4 Participants |
| Sex: Female, Male Male | 2 Participants | 35 Participants | 6 Participants | 9 Participants | 15 Participants | 3 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 29 | 0 / 29 | 0 / 24 | 0 / 24 |
| other Total, other adverse events | 0 / 29 | 0 / 29 | 0 / 24 | 1 / 24 |
| serious Total, serious adverse events | 0 / 29 | 0 / 29 | 0 / 24 | 0 / 24 |
Outcome results
Primary
Acceptable Length of CHEC, as Measured by the Number of Caregivers Who Report That the Checklist is an Acceptable Length
Acceptable length of CHEC, as measured by the number of caregivers who report that the checklist is an acceptable length
Time frame: Post intervention, at 1 week
Population: Only caregivers assigned to the CHEC condition (n=28) were analyzed for this outcome measure. The patients from these dyads were not assessed for this measure.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Caregiver Checklist (CHEC) | Acceptable Length of CHEC, as Measured by the Number of Caregivers Who Report That the Checklist is an Acceptable Length | 23 Participants |
Primary
CHEC's Ease of Use, as Measured by the Number of Caregivers Who Report That the Checklist is Easy to Use
CHEC's ease of use, as measured by the number of caregivers who report that the checklist is easy to use
Time frame: Post intervention, at 1 week
Population: Only caregivers assigned to the CHEC condition (n=28) were analyzed for this outcome measure. The patients from these dyads were not assessed for this measure.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Caregiver Checklist (CHEC) | CHEC's Ease of Use, as Measured by the Number of Caregivers Who Report That the Checklist is Easy to Use | 25 Participants |
Primary
CHEC's Helpfulness in Identify Caregivers' Needs, as Measured by the Number of Caregivers Who Report That the Checklist is Helpful in Identifying Their Needs
CHEC's helpfulness in identify caregivers' needs, as measured by the number of caregivers who report that the checklist is helpful in identifying their needs
Time frame: Post intervention, at 1 week
Population: Only caregivers assigned to the CHEC condition (n=28) were analyzed for this outcome measure. The patients from these dyads were not assessed for this measure.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Caregiver Checklist (CHEC) | CHEC's Helpfulness in Identify Caregivers' Needs, as Measured by the Number of Caregivers Who Report That the Checklist is Helpful in Identifying Their Needs | 20 Participants |
Primary
CHEC's Helpfulness in Starting a Conversation With Health Care Providers About Caregivers' Needs, as Measured by the Number of Caregivers Who Report That the Checklist is Helpful in Starting a Conversation With Providers About Their Needs
CHEC's helpfulness in starting a conversation with health care providers about caregivers' needs, as measured by the number of caregivers who report that the checklist is helpful in starting a conversation with providers about their needs
Time frame: Post intervention, at 1 week
Population: Only caregivers assigned to the CHEC condition (n=28) were analyzed for this outcome measure. The patients from these dyads were not assessed for this measure.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Caregiver Checklist (CHEC) | CHEC's Helpfulness in Starting a Conversation With Health Care Providers About Caregivers' Needs, as Measured by the Number of Caregivers Who Report That the Checklist is Helpful in Starting a Conversation With Providers About Their Needs | 22 Participants |
Primary
Desire to Continue Use, as Measured by the Number Caregivers Who Report That They Desire to Continue Using the Checklist in the Future
Desire to continue use, as measured by the number caregivers who report that they desire to continue using the checklist in the future
Time frame: Post intervention, at 1 week
Population: Only caregivers assigned to the CHEC condition (n=28) were analyzed for this outcome measure. The patients from these dyads were not assessed for this measure.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Caregiver Checklist (CHEC) | Desire to Continue Use, as Measured by the Number Caregivers Who Report That They Desire to Continue Using the Checklist in the Future | 15 Participants |
Primary
Discussion of Caregivers' Needs, as Measured by the Number of Completed Checklists That Result in a Conversation With Providers About Caregiver Needs/Concerns
Discussion of caregivers' needs, as measured by the number of completed checklists that result in a conversation with providers about caregiver needs/concerns
Time frame: Post intervention, at 1 week
Population: Only caregivers assigned to the CHEC condition (n=28) were analyzed for this outcome measure. The patients from these dyads were not assessed for this measure.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Caregiver Checklist (CHEC) | Discussion of Caregivers' Needs, as Measured by the Number of Completed Checklists That Result in a Conversation With Providers About Caregiver Needs/Concerns | 22 checklists |
Primary
The Number of Caregivers Who Complete the Checklist
The number of caregivers who complete the checklist
Time frame: Through study completion, up to 1 year
Population: Only caregivers assigned to the CHEC condition (n=28) were analyzed for this outcome measure. The patients from these dyads were not assessed for this measure.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Caregiver Checklist (CHEC) | The Number of Caregivers Who Complete the Checklist | 28 Participants |