GAPcareAD: A Brief Emergency Department Intervention to Address Post-Fall Care Needs of Persons Living With Dementia and Care Partners
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Fall Prevention.
- Who it may be relevant to
- Registry conditions: Alzheimer's Disease and Related Dementia. Basic parameters: from 65 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
Persons living with dementia (PLWD) are at significantly increased risk for falls, which are the leading cause of emergency department (ED) visits in this population and contribute to serious injuries, functional decline, and caregiver burden. GAPcareAD is an ED-initiated, caregiver-inclusive intervention designed to address fall risk at the point of care. This multi-site trial will compare GAPcareAD (intervention) to usual care for 350 PLWD and caregivers after a fall.
Detailed description
This multi-site randomized controlled trial will evaluate the efficacy of GAPcareAD compared to usual care among 350 PLWD and their caregivers (dyads) presenting to one of the three EDs after a fall. The intervention includes pharmacist- and physical therapist-led assessments, targeted modification of fall risk factors, and coordinated communication of fall prevention plans with caregivers and care teams. Outcomes include fall-related ED visits, injuries, hospitalizations, quality of life, caregiver burden, and adherence to recommendations over 6 months. GAPcareAD aims to determine whether a pragmatic, ED-based intervention can reduce fall-related healthcare utilization and improve patient and caregiver outcomes, while informing future large-scale implementation.
Interventions
- Other Fall Prevention
GAPcareAD - Pharmacists perform medication review and recommend modifying fall risk increasing medication. PTs perform fall risk assessments and tailor recommendations based on fall risk and patient's gait, balance, and mobility impairments. Through purposeful engagement by staff, caregivers are encouraged to contribute to the action plans.
Primary outcome measures
- Effect of intervention [Time frame: 6 months]
Eligibility criteria
Inclusion criteria
- Community-dwelling adult (living at home or assisted living) 65 years-old or older presenting to ED after a fall within the last seven days
- Fall not due to syncope or external force (i.e., struck by car,assault, intoxication)
- Fall not due to serious illness (i.e., stroke, acute myocardial infarction)
- Patients have an identified caregiver
- Patient must have known ADRD or score ≥2 on the AD8 Dementia Interview.
- Anticipated to be discharged to home/assisted living/rehabilitation at the time of consent (i.e. not admitted)
- The patient and/or caregiver have a reliable phone number where they can be reached throughout the intervention
Exclusion criteria
- Living in a nursing home
- Patients are admitted to the hospital
- Patients who have advanced cancer and/or are in hospice
- Patients have presence of injuries that prevent mobilization (i.e. pelvic or lower extremity fractures)
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Prevention
Study locations
Center list to be confirmed — check the primary protocol.
Identifiers
NCT: NCT07563270 · 24-1704 · NIH Grant: R01AG091334