N/A
N=385
Improving How People Living With Dementia Are Selected for Care Coordination
Dementia
Bottom Line
View on ClinicalTrials.gov: NCT05651308 ↗Enrolled (actual)
385
Serious AEs
25.2%
Results posted
Mar 2025
Primary outcome: Primary: Number of Emergency Department Visits or Hospital Admissions — 0.33; 0.35 events per 100 person-days alive
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Care coordination delivered based on perceived need (Behavioral); Care coordination delivered based on usual care (e.g. discharge from hospital) (Behavioral)
- Age
- Older Adult · 65+ yrs
- Sex
- All
- Sponsor
- Weill Medical College of Cornell University
- Primary completion
- Apr 2024
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Emergency Department Visits or Hospital Admissions |
0.33; 0.35 | — |
| SECONDARY Acceptability |
19; 14 | 0.37 |
| SECONDARY Appropriateness |
19; 14 | — |
| SECONDARY Fidelity |
19; 14 | — |
| SECONDARY Efficiency |
77; 54 | — |
Summary
Many people living with dementia (PLWD) and their care partners may benefit from the assistance of a care coordinator, a member of the medical team who facilitates communication among all the people involved. However, care coordinators' time is limited, and there is uncertainty about which patients should be selected to receive their help. This pragmatic clinical trial embedded in an accountable care organization will determine the comparative effectiveness of two approaches for assigning care coordinators to PLWD.
Eligibility Criteria
Inclusion Criteria
- Medicare beneficiaries ≥65 years old who:
- Are attributed to the NewYork Quality Care accountable care organization by Medicare,
- Have dementia (as measured in claims using the Bynum standard 1-year definition),
- Reside in the community, and
- Had fragmented ambulatory care in the previous 12 months (defined as a reversed Bice-Boxerman Index greater than or equal to the median score for this population, using Medicare claims)
Exclusion Criteria
- Those who reside in long-term care or nursing home facilities (based on addresses in Medicare claims), or
- Enrolled in home hospice
Data sourced from ClinicalTrials.gov (NCT05651308). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.