GAPcareAD: A Brief Emergency Department Intervention to Address Post-Fall Care Needs of Persons Living With Dementia and Care Partners
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 700
- 主要终点
- Effect of intervention
研究概览
简要总结
Persons living with dementia (PLWD) are at significantly increased risk for falls, which are the leading cause of emergency department (ED) visits in this population and contribute to serious injuries, functional decline, and caregiver burden. GAPcareAD is an ED-initiated, caregiver-inclusive intervention designed to address fall risk at the point of care. This multi-site trial will compare GAPcareAD (intervention) to usual care for 350 PLWD and caregivers after a fall.
详细描述
This multi-site randomized controlled trial will evaluate the efficacy of GAPcareAD compared to usual care among 350 PLWD and their caregivers (dyads) presenting to one of the three EDs after a fall. The intervention includes pharmacist- and physical therapist-led assessments, targeted modification of fall risk factors, and coordinated communication of fall prevention plans with caregivers and care teams. Outcomes include fall-related ED visits, injuries, hospitalizations, quality of life, caregiver burden, and adherence to recommendations over 6 months. GAPcareAD aims to determine whether a pragmatic, ED-based intervention can reduce fall-related healthcare utilization and improve patient and caregiver outcomes, while informing future large-scale implementation.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Community-dwelling adult (living at home or assisted living) 65 years-old or older presenting to ED after a fall within the last seven days
- •Fall not due to syncope or external force (i.e., struck by car,assault, intoxication)
- •Fall not due to serious illness (i.e., stroke, acute myocardial infarction)
- •Patients have an identified caregiver
- •Patient must have known ADRD or score ≥2 on the AD8 Dementia Interview.
- •Anticipated to be discharged to home/assisted living/rehabilitation at the time of consent (i.e. not admitted)
- •The patient and/or caregiver have a reliable phone number where they can be reached throughout the intervention
排除标准
- •Living in a nursing home
- •Patients are admitted to the hospital
- •Patients who have advanced cancer and/or are in hospice
- •Patients have presence of injuries that prevent mobilization (i.e. pelvic or lower extremity fractures)
研究组 & 干预措施
Intervention
GAPcareAD - See intervention description.
干预措施: Fall Prevention (Other)
Usual Care
The ED clinician will perform a standard medical evaluation and care.
结局指标
主要结局
Effect of intervention
时间窗: 6 months
The primary outcome is the number of fall-related emergency department visits per participant within 6 months after randomization, comparing participants receiving the GAPcareAD intervention verses usual care.
次要结局
未报告次要终点
研究者
Elizabeth Goldberg
Associate Professor
University of Colorado, Denver