GPS Clinical Intervention for Dementia
Recruiting in Palo Alto (17 mi)
+1 other location
Age: 65+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: CHU de Quebec-Universite Laval
Disqualifiers: Palliative care, Non-French speakers, others
No Placebo Group
Trial Summary
What is the purpose of this trial?
The model of care tested in the GPS project aims to optimize pharmacotherapy for seniors undergoing cognitive assessment or suffering from major neurocognitive disorder (MCND) at home. The goal is to reduce polymedication, inappropriate medications and the treatment burden of seniors and to maintain their cognitive health, quality of life and autonomy. The intervention will include knowledge exchange sessions with nurses, pharmacists, and doctors in FMGs, and increased collaboration between these professionals and home care services teams. Other goal is to increase the satisfaction of the seniors, their families, and the professionals involved in the GPS project.
Will I have to stop taking my current medications?
The trial does not specify if you need to stop taking your current medications, but it aims to optimize your medication use. It's best to discuss your specific situation with the trial team.
What data supports the effectiveness of the GPS clinical intervention treatment for dementia?
How does the GPS Clinical Intervention treatment for dementia differ from other treatments?
The GPS Clinical Intervention for dementia is unique because it focuses on psycho-social interventions, which have been shown to positively impact patients and their caregivers, potentially delaying the need for nursing home admission. Unlike some other treatments, it does not involve routine imaging or the prescription of cholinesterase inhibitors or memantine, which are not recommended by general practitioners.26789
Eligibility Criteria
This trial is for seniors aged 65 or older who have been diagnosed with cognitive impairment or major neurocognitive disorder (MCND) within the last year and are receiving home care. They must be referred to a memory clinic or pharmacist, taking prescription medications, and able to answer questionnaires in French without help.Inclusion Criteria
Having been diagnosed with cognitive impairment within the last year
With MCND and followed up at home
You have been referred to a clinic that specializes in memory-related issues.
See 7 more
Exclusion Criteria
Seniors in palliative care
Unable to answer questionnaires in French without a caregiver.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Intervention
Participants receive the GPS intervention aimed at optimizing pharmacotherapy and supporting autonomy
6 months
Regular visits with FMG team
Follow-up
Participants are monitored for changes in quality of life, treatment burden, and medication use
6 months
2 visits (in-person)
Treatment Details
Interventions
- GPS clinical intervention (Behavioural Intervention)
Trial OverviewThe GPS clinical intervention being tested aims to optimize medication use among seniors with MCND at home. It involves knowledge sharing sessions between nurses, pharmacists, doctors in Family Medicine Groups (FMGs), and collaboration with home care service teams.
Participant Groups
2Treatment groups
Experimental Treatment
Active Control
Group I: Exposed FMGs to GPS interventionExperimental Treatment1 Intervention
Patients who are followed by FMGs exposed to the GPS intervention. They will receive the GPS intervention.
Group II: Non exposed FMGs to GPS interventionActive Control1 Intervention
Patients who are part of the FMGs not exposed to the GPS intervention. They will receive the usual care and services.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
GMF AbénakisSaint-Georges, Canada
GMF Bordeaux-CartiervilleMontréal, Canada
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Who Is Running the Clinical Trial?
CHU de Quebec-Universite LavalLead Sponsor
CISSS de Chaudière-AppalachesCollaborator
CIUSSS du Nord-de-l'Île-de-MontréalCollaborator
Fonds de la Recherche en Santé du QuébecCollaborator
References
Have Quality and Outcomes Framework Depression Indicators changed referrals from primary care to a dedicated memory clinic? [2021]The proportion of patients referred from primary care to dedicated dementia clinics who receive a final diagnosis of dementia is low. Many of these non-demented patients may have depressive disorders, since depression is the most common differential diagnosis of dementia. The UK general practitioner (GP) General Medical Services contract, introduced in April 2006, included a Quality and Outcomes Framework (QOF) with indicators related to depression. We investigated whether introduction of the QOF Depression Indicators changed the pattern of referrals from primary care to a dedicated dementia clinic. The results indicated that the null hypothesis could not be rejected.
[Summary of Dutch College of General Practitioners' (NHG) practice guideline 'Dementia']. [2015]Dementia is a clinical diagnosis which a general practitioner can either make him/herself or by specific referral. If no abnormalities are found on further clinical investigations by the GP, the risk of missing a treatable cause of dementia is very small; therefore routine imaging examinations are not necessary. GPs are not recommended to prescribe cholinesterase inhibitors or memantine. The implementation of various psycho-social interventions has a positive effect on patients and their home carers and can postpone admission to a nursing home. Dementia care requires working agreements and collaboration amongst local care providers.
Practices in diagnosis, disclosure and pharmacotherapeutic management of dementia by general practitioners--a national survey. [2018]To explore the practice patterns of general practitioners (GPs) for the diagnosis, disclosure and pharmacological management of individuals with dementia. We also investigated whether the number of years working in general practice is a determinant factor associated with the responses obtained.
[The management of dementia patients from the point of view of office-based general practitioners (GPs) and specialists--the results of an empirical investigation]. [2019]The objective of the trial was to investigate the differences in the management of cognitively impaired and demented patients in Germany between GPs and neurologists/psychiatrists in private practice.
Risk of Care Home Placement following Acute Hospital Admission: Effects of a Pay-for-Performance Scheme for Dementia. [2022]The Quality and Outcomes Framework, or QOF, rewards primary care doctors (GPs) in the UK for providing certain types of care. Since 2006, GPs have been paid to identify patients with dementia and to conduct an annual review of their mental and physical health. During the review, the GP also assesses the carer's support needs, including impact of caring, and ensures that services are co-ordinated across care settings. In principle, this type of care should reduce the risk of admission to long-term residential care directly from an acute hospital ward, a phenomenon considered to be indicative of poor quality care. However, this potential effect has not previously been tested.
The development and evaluation of peer-facilitated dementia workshops in general practice. [2022]Rising dementia prevalence rates, combined with the policy objectives of integrated care in the community, means that general practitioners (GPs) are playing an increasing and pivotal role in dementia care. However, GPs are challenged by dementia care and have identified it as an area of learning need. We describe the development, roll-out and evaluation of peer-facilitated workshops for GPs, as part of a national programme to support GPs in their delivery of dementia care.
Description of general practitioners' practices when suspecting cognitive impairment. Recourse to care in dementia (Recaredem) study. [2019]General practitioners (GPs) play a major role in the assessment of dementia but it is still unrecognized in primary care and its management is heterogeneous. Our objective is to describe the usual practices, and their determinants, of French GPs in this field.
[Motivation and barriers to the use of facilitator visits in general practice]. [2015]Facilitator programmes or outreach visits have proven effective in changing physician behaviour, and there is increased focus on facilitator programmes as effective strategies in continuing GP education. This article presents GP motivation and barriers to receiving a facilitator visit in connection with a newly-established facilitator programme on dementia in Vejle County.
Improving the Quality of Dementia Care in General Practice: A Qualitative Study. [2020]Background: General Practitioners (GPs) play a central role in caring for people with dementia. There is a growing demand for GP-led community-based dementia care, as advocated in the Irish National Dementia Strategy (INDS). However, there is a paucity of research exploring GPs' views on dementia care since publication of the INDS. The aim of this qualitative study is to develop a deeper understanding of how to improve the quality of dementia care in General Practice, explored from the perspective of Irish GPs. Methods: Semi-structured interviews were conducted with GPs. GPs who completed the "Dementia in Primary Care" CPD module at University College Cork in Ireland were purposively recruited. Interviews were audio-recorded, transcribed, and analyzed by thematic analysis. Results: 12 interviews were conducted with 7 female and 5 male participants. Experience in General Practice ranged from 3 to 32 years. Most GPs practiced in mixed urban-rural settings (n = 9) and had nursing home commitments (n = 8). The average interview length was 45 minutes. Six major themes emerged from the data set, including resourcing primary care, addressing disparities in secondary care, community-centered care as patient-centered care, linking a dementia network, universal access to care, and raising public awareness. Conclusion: GPs find dementia care to be a complex and challenging aspect of primary care. While education and training is advocated by GPs, service delivery must be reconfigured. This will necessitate adequate financial resourcing and the restructuring of community-based dementia care services.