University of Connecticut Health Center
Pilot Pragmatic Clinical Trial to Embed Tele-Savvy into Health Care Systems
Health Care Systems
University of Connecticut Health Center
Emory University
Dr. Fortinsky is a professor at the University of Connecticut School of Medicine, where he is a core faculty member at the UConn Center on Aging and holds the Health Net, Inc. endowed chair in geriatrics and gerontology. For more than 30 years, Dr. Fortinsky has collaborated with colleagues from a wide range of scientific disciplines, and with numerous healthcare system and community-based organization partners, to design and carry out studies intended to improve healthcare and optimize health-related outcomes for community-dwelling older adults living with Alzheimer’s disease and AD-related dementia and their families. Presently, he serves as principal investigator for studies funded by the National Institute on Aging (NIA) and the Patient-Centered Outcomes Research Institute designed to test in-home, team-based interventions targeting older adults with cognitive vulnerability due to dementia, depression, and/or a history of delirium.
RATIONALE: Efficacious interventions offering meaningful benefits to family and other informal caregivers of older adults with Alzheimer’s disease and related dementias (ADRD) would be attractive to office-based practitioners if a pragmatic linkage could be made between interventions and these types of health care settings.
OBJECTIVE: We aim to embed a pragmatic caregiver identification and invitation strategy into the daily workflow of two outpatient clinics, enabling caregivers to complete the efficacious online psychoeducational Tele-Savvy program. We also aim to evaluate Tele-Savvy effectiveness, assess implementation of the caregiver identification and invitation strategy, and determine viability of routinely collecting and storing caregiver outcomes data into the clinics’ electronic health record systems.
SETTING: Geriatric and dementia care outpatient clinics in two health care systems.
POPULATION: 100 family and other informal caregivers of older adults living at home with ADRD who are patients in the two outpatient care settings.
DESIGN: At each clinical site, caregivers will be recruited in three sequential cohorts. Within each cohort, caregivers will be randomly assigned to join a Tele-Savvy program or to access an online self-guided program about caregiving during crisis. We also will carry out an implementation evaluation to determine clinical staff acceptability and willingness to adopt Tele-Savvy as a routinely-offered caregiver psychoeducational program.
OUTCOMES: Primary outcome is self-reported caregiver mastery. Secondary outcomes are self-reported caregiver reactions to memory and behavior problems, and self-reported perceived stress. All of these outcomes were used in the Tele-Savvy intervention efficacy trial.
IMPACT: If this pilot study successfully achieves its objectives, we will be poised to design a large embedded pragmatic trial engaging sites from the large pool of geriatric and dementia care clinics nationwide. Our longterm goal is to routinely offer Tele-Savvy to caregivers, and to routinely store caregiver outcome data, in health care systems that provide outpatient care to people living with ADRD and their families.