Recruitment for a Multisite Pragmatic Trial of Dementia Care Strategies: Barriers and Success During COVID-19

Chair(s)

• 

  David Reuben, MD

  Chief, division of geriatrics
  Medicine - Geriatrics
  David Geffen School of Medicine at UCLA
  Los Angeles, California, United States

  Slides

Discussant(s)

• KM

  Katie Maslow, MSW

  Geriatrics
  Gerontological Society of America
  Washington, District of Columbia, United States

Individual Symposium Abstract First Author(s)

• 

  Mia Yang, MD, MS

  Assistant Professor
  Internal Medicine - Section on Gerontology & Geriatric Medicine
  Wake Forest School of Medicine
  Winston-Salem, North Carolina, United States
• 

  Rafael Samper-Ternent, MD, PhD (he/him/his)

  Associate Professor
  Department of Internal Medicine
  The University of Texas Health Science Center in Houston
  Houston, Texas, United States
• 

  Maya Lichtenstein, MD, MHSc

  Associate Neurologist
  Department of Neurology
  Geisinger Health System
  Wilkes Barre, Pennsylvania, United States
• 

  Alan Stevens, PhD, FGSA

  Director, Center for Applied Health Research
  Center for Applied Health Research
  Baylor Scott and White Health
  Temple, Texas, United States

With 2176 participants recruited, D-CARE is the largest pragmatic clinical trial of dementia care strategies, to date. At four clinical trial sites (CTS), D-CARE will compare the effectiveness of three dementia care strategies over 18 months: 1) by nurse practitioners or physician assistants within a health care system, 2) by social workers or nurses at community-based service organizations (CBO), or 3) usual care. Primary outcomes include person with dementia (PWD) behavioral symptoms and caregiver strain. Other outcomes include the PWD quality of life and ability to reach personal goals, and caregiver self-efficacy, distress, and depressive symptoms. Recruitment began in June 2019 with a basic protocol in which participating providers reviewed lists generated from the electronic health records (EHR) of patients who had a diagnosis of dementia, allowing the removal of patients who should not be contacted and giving an opportunity to provide information about the family caregiver. Some practices gave “blanket” referral allowing research staff to recruit participants directly. Other practices provided direct referrals via EHR communications to the research team. Self-referrals triggered by public postings in clinics and CBOs, social media, and media coverage were also accepted if a dementia diagnosis was confirmed in the EHR. By March 16, 2020, all in-person recruitment visits were suspended due to COVID-19. In response, informed consent was switched to telephone with verbal consent as permitted by State and Institutional regulations. This symposium describes the creative approaches employed by CTS’ to respond to these challenges and reach the recruitment goal in January 2022.

Presentations:

• 8:00 AM – 9:30 AM ET

  Electronic Health Record Screening for Persons Living with Dementia in D-CARE
  

  Individual Symposium Abstract First Author: Mia Yang, MD, MS – Wake Forest School of Medicine
• 8:00 AM – 9:30 AM ET

  Focusing on Diversity: UTMB Recruitment Strategy for the D-CARE Study
  

  Individual Symposium Abstract First Author: Rafael Samper-Ternent, MD, PhD (he/him/his) – The University of Texas Health Science Center in Houston
• 8:00 AM – 9:30 AM ET

  Enrolling Participants with Dementia in a Rural Setting: Geisinger Recruitment Strategies for D-CARE
  

  Individual Symposium Abstract First Author: Maya L. Lichtenstein, MD, MHSc – Geisinger Health System
• 8:00 AM – 9:30 AM ET

  Clinic-Based Recruitment Strategies Within an Integrated Health Care System for the Dementia Care Study (D-CARE)
  

  Individual Symposium Abstract First Author: Alan B. Stevens, PhD, FGSA – Baylor Scott and White Health