Dementia, Alzheimer Disease
Conditions
Brief summary
The eRADAR Brain Health Study seeks to refine and test a novel, low-cost strategy for increasing dementia detection within primary care.
Detailed description
eRADAR stands for electronic health record (EHR) Risk of Alzheimer's and Dementia Assessment Rule. It is a low-cost tool or algorithm that uses readily available EHR data elements to identify high-risk patients. We will conduct a pragmatic randomized controlled trial to assess the impact of implementing eRADAR as part of a supported outreach process on dementia detection rates. We will also explore the impact of eRADAR implementation on healthcare utilization and patient experience.
Interventions
Research interventionists, who will be trained and licensed health practitioners (e.g., social workers), will ask participants about changes in memory or thinking and daily function, screen for depression, and administer a standard cognitive screening test. They will use a standardized note template to document results in the participant's EHR. Research interventionists will notify participants and PCPs if follow-up is recommended.
Sponsors
University of California, San Francisco
Kaiser Permanente
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SCREENING
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* No prior diagnosis of dementia (defined from EHR diagnosis codes) and not receiving medications for dementia * Active patient at participating clinic * Adequate data to calculate eRADAR score
Exclusion criteria
\- Currently receiving hospice care
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| New dementia diagnoses | 12 months after index date | Rate of new dementia diagnoses identified from the electronic health record (EHR) using a prespecified set of ICD-10 codes |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Dementia medications | 6 months after index date | Percent of participants who receive new medications for dementia, defined from medication orders or dispensings in the electronic health record |
| Urgent care/emergency department visits | 1 year after index date | Number of urgent care and emergency department visits |
| Hospitalizations | 1 year after index date | Number of inpatient stays |
| Clinic no shows | 1 year after index date | Number of scheduled visits missed |
| Healthcare utilization | 6 months after index date | Number of primary care visits, laboratory tests performed, neuroimaging tests, and specialty visits or referrals, defined from EHR data |
| New dementia diagnoses (secondary definitions) | 6 months after index date; 18 months after index date | Dementia diagnosis rate in different time periods than for primary outcome, defined from EHR data |
| New diagnoses of mild cognitive impairment | 12 months after index date | Rate of new diagnoses of mild cognitive impairment following the intervention, defined from EHR data |
| Rate of accepting brain health visit | 3 months after invitation mailed | Proportion of people offered a brain health visit who accept and attend the visit |
| Positive predictive value of eRADAR algorithm | 12 months after index date | Proportion of people with a high risk eRADAR Score who attend a brain health visit who are diagnosed with dementia |
| Medication adherence | 1 year after index date | Proportion of days covered |
Countries
United States
Outcome results
None listed