The eRADAR Brain Health Study seeks to refine and test a novel, low-cost strategy for increasing dementia detection within primary care.
Detailed description: 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. The investigators 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. The investigators will also explore the impact of eRADAR implementation on healthcare utilization and patient experience.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Masking
NONE
Enrollment
1,271
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. Research interventionalists 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.
UCSF Primary Care at China Basin
San Francisco, California, United States
Division of General Internal Medicine
San Francisco, California, United States
Women's Health Primary Care
San Francisco, California, United States
New dementia diagnosis
Rate of new dementia diagnosis identified from the electronic health record (EHR) using prespecified set of ICD-10 codes
Time frame: 12 months after index date
Number of primary care visits
Defined from EHR data
Time frame: 6 months after index date
Number of dementia-related laboratory tests performed
Defined from EHR data
Time frame: 6 months after index date
Number of dementia-related neuroimaging tests performed
Defined from EHR data
Time frame: 6 months after index date
Number of specialty visits or referrals for dementia assessment
Defined from EHR data
Time frame: 6 months after index date
Percent of participants who receive new medications for dementia
Defined from medication orders or dispensings in the electronic health record
Time frame: 6 months after index date
Number of urgent care and emergency department visits
Defined from EHR data
Time frame: 1 year after index date
Number of inpatient days
Defined from EHR data
Time frame: 1 year after index date
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Number of scheduled visits missed
Clinic "no shows"
Time frame: 1 year after index date
Proportion of days covered for current prescriptions
Standard measure of medication adherence
Time frame: 1 year after index date
New dementia diagnosis (secondary definitions)
Rate of new dementia diagnosis identified from the electronic health record (EHR) using prespecified set of ICD-10 codes
Time frame: 6 months after index date
New dementia diagnosis (secondary definitions)
Rate of new dementia diagnosis identified from the electronic health record (EHR) using prespecified set of ICD-10 codes
Time frame: 18 months after index date
New diagnosis of mild cognitive impairment
Rate of new diagnosis of mild cognitive impairment following the intervention, defined from EHR data
Time frame: 12 months after index date
Proportion of people offered a brain health visit who accept and attend the visit
Rate of accepting brain health visit
Time frame: 3 months after invitation mailed
Positive predictive value of eRADAR algorithm
Proportion of people with a high risk eRADAR Score who attend a brain health visit who are diagnosed with dementia
Time frame: 12 months after index date