Ignite Creation Date:
2024-05-11 @ 8:30 AM
Last Modification Date:
2024-10-26 @ 3:29 PM
Study NCT ID:
NCT06404970
Status:
RECRUITING
Last Update Posted:
2024-05-08
First Post:
2024-04-10
Brief Title:
A Partnered Evaluation to Improve the Identification and Management of Functional Impairment and Frailty Among Older Veterans in Primary Care Settings
Sponsor:
VA Office of Research and Development
Organization:
VA Office of Research and Development
Study Overview
Official Title:
A Partnered Evaluation to Improve Identification and Management of Functional Impairment and Frailty for Older Veterans in VA Primary Care
Status:
RECRUITING
Status Verified Date:
2024-07
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Maintaining functional status or the ability to perform daily activities is central to older adults quality of life health and ability to remain independent Identifying functional impairments is essential for clinicians to provide optimal care to older adults and on a population level understanding function can help anticipate service needs Yet uptake of standardized measurement of functional status into patient care has been slow and inconsistent due to the burden posed by current tools The purpose of the proposed QUERI Partnered Evaluation Initiative is to implement and evaluate a patient-centered low-burden intervention to improve measurement of functional status in VA primary care settings nationally The investigators hypothesize that implementing this intervention will increase identification and improve management of functional impairment among older Veterans while providing key data to inform VHA strategic planning related to long-term services and supports
Detailed Description:
Background Maintaining functional status or the ability to perform daily activities such as bathing dressing and preparing meals is central to older adults quality of life health and ability to remain independent Identifying functional impairments - defined as having difficulty or needing help performing these activities - is essential for clinicians to provide optimal care to older adults and on a population level understanding function can help anticipate service needs Yet uptake of standardized measurement of functional status into routine patient care has been slow and inconsistent due to the burden posed by current tools The purpose of the proposed QUERI Partnered Evaluation Initiative is to implement and evaluate the Patient-Aligned Care Team PACT Functional Status Screening Initiative hereafter PACT Function Initiative a patient-centered low-burden intervention to improve measurement of functional status in VA primary care settings nationally
SignificanceImpact Implementing routine measurement of functional status in primary care has the potential to improve identification and management of functional impairment for older Veterans Improved management includes increasing access to services and supports reducing potentially preventable acute care utilization and allowing Veterans to live in the least restrictive setting for as long as possible The proposed QUERI Partnered Evaluation Initiative is directly aligned with national VA strategic priorities including VAs Aging in Place and Aging and Frail Veterans initiatives Objective 22 and developing Data as a Strategic Asset Objective 42 to inform evidence-based decisions
Innovation The PACT Function Initiative is novel because it addresses prior barriers to functional status measurement It incorporates Veteran and caregiver preferences while minimizing burden for primary care teams and maximizing clinical effectiveness Implementing this intervention will provide functional status data that is directly actionable for patient care while creating a repository of data to inform VA strategic planning
Specific Aims 1 Measure clinician- and organization-level reach adoption implementation and sustainment of the PACT Function Initiative 2 Compare the effectiveness of a standard versus enhanced implementation bundle to improve adoption 3 Measure patient-level clinical effectiveness of the intervention and 4 To inform future GEC initiatives test the effectiveness of EHR-based frailty screening for identifying Veterans at risk for functional impairment The investigators hypothesize that implementing the PACT Function Initiative will result in increased identification and improved management of functional impairment among older Veterans while providing key data to inform VHA strategic planning related to long-term services and supports
Methodology In partnership with GEC and Primary Care the investigators will implement and evaluate the PACT Function Initiative using a hybrid type 2 implementation-effectiveness cluster-randomized adaptive trial design with three phases pre-implementation implementation and sustainment The investigators will use the Practical Robust Implementation and Sustainability Model PRISM to guide implementation and evaluation During pre-implementation the investigators will engage stakeholders and develop local adaptations to maximize intervention-setting fit During implementation the investigators will launch a standard bundle of implementation strategies champions system-level audit and feedback identify sites with low uptake and randomize those sites to receive continued standard vs enhanced strategies technical assistance clinician-level audit and feedback
Next StepsImplementation Establishing routine standardized measurement of functional status and frailty among older Veterans will provide data to inform the delivery of proactive interventions to prevent and delay the development of functional impairment and improve quality of life health and independence
SignificanceImpact Implementing routine measurement of functional status in primary care has the potential to improve identification and management of functional impairment for older Veterans Improved management includes increasing access to services and supports reducing potentially preventable acute care utilization and allowing Veterans to live in the least restrictive setting for as long as possible The proposed QUERI Partnered Evaluation Initiative is directly aligned with national VA strategic priorities including VAs Aging in Place and Aging and Frail Veterans initiatives Objective 22 and developing Data as a Strategic Asset Objective 42 to inform evidence-based decisions
Innovation The PACT Function Initiative is novel because it addresses prior barriers to functional status measurement It incorporates Veteran and caregiver preferences while minimizing burden for primary care teams and maximizing clinical effectiveness Implementing this intervention will provide functional status data that is directly actionable for patient care while creating a repository of data to inform VA strategic planning
Specific Aims 1 Measure clinician- and organization-level reach adoption implementation and sustainment of the PACT Function Initiative 2 Compare the effectiveness of a standard versus enhanced implementation bundle to improve adoption 3 Measure patient-level clinical effectiveness of the intervention and 4 To inform future GEC initiatives test the effectiveness of EHR-based frailty screening for identifying Veterans at risk for functional impairment The investigators hypothesize that implementing the PACT Function Initiative will result in increased identification and improved management of functional impairment among older Veterans while providing key data to inform VHA strategic planning related to long-term services and supports
Methodology In partnership with GEC and Primary Care the investigators will implement and evaluate the PACT Function Initiative using a hybrid type 2 implementation-effectiveness cluster-randomized adaptive trial design with three phases pre-implementation implementation and sustainment The investigators will use the Practical Robust Implementation and Sustainability Model PRISM to guide implementation and evaluation During pre-implementation the investigators will engage stakeholders and develop local adaptations to maximize intervention-setting fit During implementation the investigators will launch a standard bundle of implementation strategies champions system-level audit and feedback identify sites with low uptake and randomize those sites to receive continued standard vs enhanced strategies technical assistance clinician-level audit and feedback
Next StepsImplementation Establishing routine standardized measurement of functional status and frailty among older Veterans will provide data to inform the delivery of proactive interventions to prevent and delay the development of functional impairment and improve quality of life health and independence
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
False
Is an FDA AA801 Violation?:
None
Secondary IDs
| Secondary ID | Type | Domain | Link |
|---|---|---|---|
| PEC 23-072 | OTHER_GRANT | VA Quality Enhancement Research Initiative | None |