Program of Intensive Support in Emergency Departments for Care Partners of Cognitively Impaired Patients

Study Overview
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Brief Summary
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Dementia is a common problem for older patients presenting to emergency departments and for the family caregivers who often lack support, understanding, and skills to manage the problems related to the need for emergency department visits. The purpose of Program of Intensive Support in Emergency Departments for Care Partners of Cognitively Impaired Patients (POISED-CPCIP, here on referred to as POISED) randomized controlled trial is to use previously established quality improvement methods of root cause analysis to uncover reasons for emergency department use and to focus on caregiver activation within a program of dementia care management. The goals of this study are to reduce recurrent emergency department visits and improve caregiver symptoms of depression, anxiety and need for social support.

Official Title
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Program of Intensive Support in Emergency Departments for Care Partners of Cognitively Impaired Patients

Conditions
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Dementia

Intervention / Treatment
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* Other: POISED Care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Must be in the emergency department for care at the point of recruitment Must be English- or Spanish-speaking Must have a family member or friend who provides caregiving assistance Must have a plan to be discharged to home (ESI = 4 or 5) Must have score <3 on the MiniCog or if using caregiver assessment by IQCODE must be >3.4 Must have capacity to consent or have a proxy. Exclusion Criteria: Care recipient (CR) is a resident of a nursing home or other supportive facility CR scores > 3 on the MiniCog or the caregiver assessment by IQCODE was < 3.4 Caregiver (CG) declines participation CR is not being discharged to home

Ages Eligible for Study
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Minimum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: POISED Care<br>Dyads randomized to the POISED Care intervention will work with the POISED care management team - consisting of specially-trained nurses functioning as care managers (CMs) and para-professionals in the role of care manager assistants (CMAs) - to create an individualized care plan through the lens of cognitive impairment with an emphasis on coordinating care with the patient's primary care provider (PCP) and achieving relevance with the goals and capacity of the family care-giver and care-recipient. | Other: POISED Care<br>* Program of dementia care management.<br>|
| No Intervention: Usual Care<br>Participants will receive referrals to services at the time of enrollment. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of Participants With an Emergency Department (ED) Visit Within 6 Months After Enrollment | Percentage of participants who visit the ED within 6 months of being enrolled. | Up to Month 6 |