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Piloting the IPROACTIF Program to Preserve Functioning and Prevent Cognitive Decline

Not Applicable
Completed
Conditions
Heart Disease (Coronary Artery Disease, Ischemic Heart Disease, Hypertensive Heart Disease)
Uncontrolled Diabetes (HBA1c ≥ 10)
Interventions
Other: IPROACTIF (Integrated PRimary Care and Occupational Therapy for Aging and Chronic Disease Treatment to preserve Independence and Functioning)
Other: Usual primary care services
Registration Number
NCT04682977
Lead Sponsor
University of Illinois at Chicago
Brief Summary

Conduct a pilot randomized control to assess the preliminary efficacy of IPROACTIF, an occupational therapist-delivered primary care intervention for aging and chronic disease management.

Detailed Description

The IPROACTIF intervention is based on the premise of preventing the physical and cognitive decline that is associated with aging and chronic disease. The 12-week intervention includes a comprehensive assessment of ADL functioning and ten intervention sessions addressing disease management, physical activity and executive functioning. This pilot randomized control trial will compare whether patients who receive IPROACTIF perform better than usual care patients on physical functioning, self-efficacy for chronic disease management, physical activity levels, executive functioning, health-related quality of life, and participation in life roles and activities.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
45
Inclusion Criteria
  • English speaking
  • Community-dwelling
  • 55 years of age
  • Primary diagnosis of heart disease (coronary artery disease, ischemic heart disease, hypertensive heart disease), or uncontrolled diabetes (HBA1c greater than/equal to 10)
  • Self-reported risk of functional decline (score of 3 or higher) on the 11-item Brief Risk Identification of Geriatric Health Tool or self-reported need for assistance with disease management

Exclusion Criteria

  • Current/past diagnosis of stroke or other neurological disorders
  • Receiving pharmacological treatment for cognition
  • Participating in other exercise or ADL-focused intervention studies
  • Non-English speaking
  • Residing in a long-term care institution
  • Compromised decision-making capacity (score >8 on SOMCT)
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
IPROACTIFIPROACTIF (Integrated PRimary Care and Occupational Therapy for Aging and Chronic Disease Treatment to preserve Independence and Functioning)10 weekly sessions. First two sessions focus on comprehensive assessment of physical and executive functioning, assessment of home safety and accessibility, assessment of ADL/IADL competence and performance in context; information in these areas is used by the interventionist to collaboratively identify three patient-centered goals. Goal planning is followed by 10 treatment sessions. Treatment sessions focus on chronic disease education, problem solving issues related to disease management by modifying daily routines, recommendations for embedding physical activity in everyday tasks, and environmental modifications or activity adaptations to increase ADL/IADL independence.
Usual careUsual primary care servicesParticipants in the control group will receive usual services which might include primary care and prescription medications for chronic disease management.
Primary Outcome Measures
NameTimeMethod
Physical functioning measured using the PROMIS Physical Function Short Form 2012 weeks

Self-reported assessment with raw scores ranging from 20 to 100; higher scores indicate better physical functioning

Performance of daily living tasks using the Performance Assessment of Self-care Skills12 weeks

Performance-based measure; summary score for each task ranges from 0-12; higher scores indicate better performance

Physical functioning measured using the Patient-Specific Functional Scale12 weeks

Self-reported assessment; scoring depends on number of activities rated, for a single activity, scores can range from 0 to 10; higher scores indicate better physical functioning

Physical functioning measured using the Physical Performance Test (9-item)12 weeks

Performance-based assessment; scores can range from 0 to 36; higher scores indicate better physical functioning

Executive functioning using the Dimensional Change Card Sort Test12 weeks

Performance-based measure; scores range from 0-10; higher scores indicate better performance

Executive functioning using the Executive Function Performance Test12 weeks

Performance-based measure; only the medication management task will be used; scores range from 0-25 for this task; higher scores indicate poorer performance

Secondary Outcome Measures
NameTimeMethod
Physical activity level12 weeks

Total minutes per day in moderate to vigorous physical activity and sedentary activity as measured by an accelerometer worn for at least 12 hours over seven consecutive days.

Self-efficacy for chronic disease management using the Chronic Disease Self-Efficacy and Self-Management Measures12 weeks

Self-reported assessment; range of possible scores varies by subscale; generally higher scores indicate better self-efficacy and self-management

Health related quality of life using the PROMIS Global Health Measure (physical and mental subscales)12 weeks

Self-reported assessment; raw scores for both sub-scales range from 4-20; higher score indicated better health-related quality of life

Participation in life activities and roles using the Late Life Functioning and Disability Index12 weeks

Self-rated measure; scaled scores for both dimensions (frequency and limitation) range from 0-100; higher scores indicate less difficulty i.e. better performance

Trial Locations

Locations (1)

University of Illinois at Chicago

🇺🇸

Chicago, Illinois, United States

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