Telemedicine-based, Multidisciplinary-team, Intervention to Reduce Unnecessary Hospitalizations

Study Overview
=================
Brief Summary
-----------------
The purpose of this study is to investigate the use of telemedicine-based intervention at urban and rural skilled nursing facilities to recommend multidisciplinary dementia care to residents with dementia who are at risk for unnecessary hospitalization due behavioral or neuropsychiatric symptoms and/or complications as well as caregivers and facility staff. The multidisciplinary team is comprised of trained behavioral neurologists, social workers, advanced practice providers, primary medical team and nurse coordinators.

Official Title
-----------------
Telemedicine-based, Multidisciplinary-team, Intervention to Reduce Unnecessary Hospitalizations and Healthcare Costs in Appalachia KY Skilled Nursing Facilities

Conditions
-----------------
Dementia Alzheimers, Disruptive Behavior

Intervention / Treatment
-----------------
* Behavioral: Behavioral modification and education on pharmacologic treatments.


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Dementia Care facility resident Problematic behavioral problems Exclusion Criteria: None
Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Supportive Care
Intervention Model: Single Group Assignment


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Telemedicine Intervention<br>Multidisciplinary telemedicine education of staff and providers on best practices for behavioral modification as well as education on best practices for pharmacologic therapies. | Behavioral: Behavioral modification and education on pharmacologic treatments.<br>* Education and counseling of care-giving staff on behavioral modification strategies, as well as education about current standard of care best practices for pharmacologic interventions.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in the Neuropsychiatric Inventory (NPI) total score | The NPI assesses 10 behavioral symptom domains, scoring is based on symptom frequency and severity. The total NPI score sums the products of frequency and severity scores for each domain. Higher scores indicate more behavioral disturbance | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in the Resource Utilization in Dementia - Formal Care (RUD-FOCA) | The RUD-FOCA records the care time in three areas: activities of daily living (ADL), instrumental activities of daily living (IADL) and supervision. | 6 months | 
| Change in Quality of Life in Alzheimers Dementia (QoL-AD) | 13 quality of life items are rated on a four point scale, with 1 being poor and 4 being excellent. Total scores range from 13 to 52. It generally takes caregivers about 5 minutes to complete the measure. | 6 months. |