SCAN Memory Program Evaluation Study

VA Greater Los Angeles Healthcare System500 enrolled

Overview

The SCAN Memory Program Evaluation study is an evaluation of a randomized controlled trial intervention consisting of a care management program for cognitively-impaired health plan members and for their informal/family caregivers. The program includes collaboration between the health plan, partnering medical groups, and community organizations. Program activities include: 1) telephonic-structured assessments with informal caregivers conducted by SCAN Memory Program care managers; 2) problem identification as a result of these assessments; and 3) pre-established protocols and procedures for problem resolution. ACCESS, the prototype for the SCAN Memory Program, was developed and tested in San Diego County and was very successful in helping affected patients and their caregivers.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

QUADRUPLE

Enrollment

500

Conditions

Dementia

Interventions

The SCAN Memory Program is a care management program for cognitively-impaired SCAN members and for their informal/family caregivers. The program includes collaboration between SCAN Health Plan, partnering medical groups, and community organizations. Program activities include: 1) telephonic-structured assessments with informal caregivers conducted by SCAN Memory Program care managers; 2) problem identification as a result of these assessments; and 3) pre-established protocols and procedures for problem resolution.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: Health plan member eligibility includes having a visit-based ICD-9 diagnostic code for dementia or a dementia-specific medication (including donepezil, rivastigmine, galantamine, and memantine) within administrative data any time prior to data inquiry for potential subjects. The health plan member must have a caregiver who can communicate by telephone and though that person might also be a health plan member, health plan membership for caregivers is not required. All subjects must be living in the community and if in a nursing facility, this must be for rehabilitation or respite care but not for long term care. Caregivers must be able to communicate in English or Spanish. Exclusion Criteria: Person with dementia whose potential participation is declined by their physician. Those who do not have a family or informal caregiver cannot participate and caregivers who do no have telephone access or the capacity to consent to research evaluation are excluded. Patients who reside in nursing facilities as permanent residents are not eligible. \-

Locations (2)

Davis Research

Calabasas, California, United States

RECRUITING

VA Greater Los Angeles Healthcare System

Los Angeles, California, United States

RECRUITING

Outcomes

Primary Outcomes

Guideline Adherence

Quality of care process measures will be examined that reflect practice guideline quality indicators measuring patient and caregiver assessment, treatment, education and support, and safety. Measures are collected at 9 and 18 months using caregiver surveys and medical record abstraction.

Time frame: 18 months of longer

Program feasibility and fidelity

Formative Evaluation consisting of a series of stakeholder semi-structured interviews and data abstraction to monitor the activities of healthplan care managers will be collected at pre-specificed intervals and results will be provivided periodically to the healthplan for ongoing improvements in program delivery.

Time frame: 6 to 18 months

Healthcare utilization

Caregiver specific utilization including use of services that care managers may recommend to them and the dementia patient. Emergency department, hospitalization and ambulatory visits data will also be collected through administrative data and caregiver surveys.

Time frame: 18 months

Secondary Outcomes

Behavioral disturbance

Neuropsychiatric inventory questionnaire (NPI-Q)as a caregiver derived assessment on caregiver surveys conducted at baseline, 9 and 18 months.

Time frame: 9 months and 18 months

Functional Status

Using an informant (caregiver)-based measure of 10 complex higher order activities using the Functional Activities Questionnaire (FAQ). This is a reliable measure of functional status in patients with dementia.

Time frame: 9 and 18 months

Quality of life

Patient health related quality of life (HRQOL) using the Health Utilities Index

Time frame: 9 and 18 months

Quality of Care

Using caregiver surveys, this will be measured with a 5-item scale from the Consumer Assessment of Health Plans Survey 2.0.

Time frame: 9 and 18 months

Caregiver self-efficacy

caregiver confidence using a 6-item measure that was utilized in prior care management clinical trials

Time frame: 9 months and 18 months

Caregiver unmet need for assistance

a 2-item, 3-point scale for each covering general caregiveing - bathing, dressing, and transportation

Time frame: 9 months and 18 months

Caregiver social support

This will be measured in caregiver surveys using a 5-item measure derived from the Medical Outcomes study Social Support Survey (MSSS).

Time frame: 9 months and 18 months

Caregiver burden

The 22-item Burden Interview is a widely used validated measure to assess stressors experienced by caregivers of persons with dementia. Each itme uses a 5-point scale (response set).

Time frame: 9 months and 18 months

Caregiver depression

The Patient Health Questionnaire - Nine (PHQ-9) will be included in caregiver surveys at baseline, 9 and 18 months as a measure of depressive symptoms over the preceding 2 weeks.

Time frame: 9 months and 18 months

Central Contacts

Joshua Chodosh, MD, MSHS

CONTACT

310-268-3361 jchodosh@mednet.ucla.edu

Karen Connor, RN, MBA, PhD

CONTACT

310-268-3975 kiconnor@ucla.edu