The Brain Health Study: A Pragmatic, Patient-Centered Trial

Kaiser Permanente3,417 enrolled

Overview

The eRADAR Brain Health Study seeks to refine and test a novel, low-cost strategy for increasing dementia detection within primary care.

eRADAR stands for "electronic health record (EHR) Risk of Alzheimer's and Dementia Assessment Rule." It is a low-cost tool or algorithm that uses readily available EHR data elements to identify high-risk patients. We will conduct a pragmatic randomized controlled trial to assess the impact of implementing eRADAR as part of a supported outreach process on dementia detection rates. We will also explore the impact of eRADAR implementation on healthcare utilization and patient experience.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SCREENING

Masking

NONE

Enrollment

3,417

Conditions

Dementia Alzheimer Disease

Interventions

Brain Health AssessmentOTHER

Research interventionists, who will be trained and licensed health practitioners (e.g., social workers), will ask participants about changes in memory or thinking and daily function, screen for depression, and administer a standard cognitive screening test. They will use a standardized note template to document results in the participant's EHR. Research interventionists will notify participants and PCPs if follow-up is recommended.

Eligibility

Sex: ALLMin age: 65 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * No prior diagnosis of dementia (defined from EHR diagnosis codes) and not receiving medications for dementia * Active patient at participating clinic * Adequate data to calculate eRADAR score Exclusion Criteria: \- Currently receiving hospice care

Locations (5)

Kaiser Permanente Burien Medical Center

Burien, Washington, United States

Kaiser Permanente Kent Medical Center

Kent, Washington, United States

Kaiser Permanente Renton Medical Center

Renton, Washington, United States

Kaiser Permanente, Capitol Hill

Seattle, Washington, United States

Outcomes

Primary Outcomes

New Dementia Diagnoses

Rate of new dementia diagnoses identified from the electronic health record (EHR) using a prespecified set of ICD-10 codes

Time frame: 12 months after index date

Secondary Outcomes

Number of Patients Who Received a New Diagnosis of Mild Cognitive Impairment or Dementia

Number of new diagnoses of mild cognitive impairment in the 12 months following study initiation, defined from EHR data

Time frame: 12 months after index date

Number of Patients Who Received New Dementia Diagnoses in 18 Months of Follow-up

Dementia diagnosis rate in 18 months defined from EHR data

Time frame: 18 months after index date

Number of Patients Who Received a New Dementia Diagnosis in 6 Months of Follow-up

Number of patients with a new dementia diagnosis in 6 months of follow-up defined from the EHR.

Time frame: 6 months

Number of Patients Who Received a New Dementia Medication

Receipt of new medications for dementia in 12 months, defined from medication orders or dispensings in the electronic health record

Time frame: 12 months after index date

Number of Patients With Urgent Care/Emergency Department Visits

Number of participants who had at least 1 urgent care or emergency department visit in the 12 months following study initiation.

Time frame: 1 year after index date

Average Number of Hospitalizations

Average number of hospitalizations (inpatient stays) per participant in the 1 year after study initiation.

Data from ClinicalTrials.gov

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