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
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. The investigators 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. The investigators 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. Research interventionalists 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
National Institute on Aging (NIA)
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 diagnosis | 12 months after index date | Rate of new dementia diagnosis identified from the electronic health record (EHR) using prespecified set of ICD-10 codes |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of primary care visits | 6 months after index date | Defined from EHR data |
| Number of dementia-related laboratory tests performed | 6 months after index date | Defined from EHR data |
| Number of dementia-related neuroimaging tests performed | 6 months after index date | Defined from EHR data |
| Number of specialty visits or referrals for dementia assessment | 6 months after index date | Defined from EHR data |
| Percent of participants who receive new medications for dementia | 6 months after index date | Defined from medication orders or dispensings in the electronic health record |
| Number of urgent care and emergency department visits | 1 year after index date | Defined from EHR data |
| Number of inpatient days | 1 year after index date | Defined from EHR data |
| Number of scheduled visits missed | 1 year after index date | Clinic "no shows" |
| Proportion of days covered for current prescriptions | 1 year after index date | Standard measure of medication adherence |
| New dementia diagnosis (secondary definitions) | 6 months after index date | Rate of new dementia diagnosis identified from the electronic health record (EHR) using prespecified set of ICD-10 codes |
| New diagnosis of mild cognitive impairment | 12 months after index date | Rate of new diagnosis of mild cognitive impairment following the intervention, defined from EHR data |
| Proportion of people offered a brain health visit who accept and attend the visit | 3 months after invitation mailed | Rate of accepting brain health 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 |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORDeborah Barnes, PhD
University of California, San Francisco
PRINCIPAL_INVESTIGATORSascha Dublin, MD, PhD
KP Washington Health Research Institute
Outcome results
None listed