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DementiaNCT00178165

Coordinating Center for Enhancing ADRD Caregiving

A study testing Skill Training Condition - problem solving training and REACH for TLC (Telephone Linked Computer) system in people with Dementia and Alzheimer Disease, run by University of Pittsburgh at 5 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Established in 1995, Resources for Enhancing Alzheimer's Caregiver Health (REACH) is a unique, multi-site research program sponsored by the National Institute on Aging (NIA) and the National Institute on Nursing Research (NINR). Read more about this study

Who is it for?
Ages 21 years and older
Conditions the study is for
Dementia, Alzheimer Disease
What is being tested?
Skill Training Condition - problem solving training and REACH for TLC (Telephone Linked Computer) system
Type of treatment
Surgery or procedure
How many people
1,200 participants
Where
5 sitesUnited States
Study dates
Sep 1996to Nov 2001
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 21 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • NINCDS -ADRDA Criteria for Alzheimer's Disease and/or DSM IV Criteria for Alzheimer's Disease or other dementia or MMSE score < 23.
  • Functional impairment: presence of two IADL or one ADL impairments.
  • Age: 21 years and older
  • Language: site specific, must be competent either orally or written
  • Lives with care recipient
  • Family member
Show all 11Show fewer
  • Gender: Palo Alto/Los Angeles will only enroll women. All other sites will enroll men and women
  • Must have a telephone
  • At enrollment, plan to remain in area for the duration of the intervention and follow-up
  • Caregiver role of at least 6 months
  • Provides > 4 hours of supervision or direct assistance per day for the care recipient

Who cannot join

  • Any terminal illness with life expectancy < 6 months
  • Active treatment (chemotherapy, radiation therapy) for cancer
  • More than three acute medical hospitalizations in past year (not for psychiatric or Alzheimer's Disease related admission)
  • Schizophrenia (onset of delusions before age 45)
  • Dementia secondary to head trauma (probable)
  • Blindness or deafness if either disability prohibits them from completion of data collection or participation in the interventions
Show all 16Show fewer
  • MMSE = 0 and bedbound (confined to a bed or chair for > 22 hours per day, for at least 4 of the past 7 days)
  • Planned nursing home admission in 6 months
  • CORE CAREGIVER INCLUSION/EXCLUSION CRITERIA
  • Any terminal illness with life expectancy < 6 months
  • Active treatment (chemotherapy, radiation therapy) for cancer
  • More than three acute medical hospitalizations in past year
  • Involved in another clinical trial of interventions for caregivers (non drug study)
  • Second Level Review If the caregiver has been inconsistent with answers or repeated answers, then the interviewer will administer the SPMSQ. The interviewer will then discuss with the PI and coordinate another phone call with the caregiver.
  • If in the course of the telephone screen the research assistant believes that there may be difficulties for the caregiver regarding travel arrangements, hesitancy to answer questions, or other specific items (site-specific indications), the research assistant will refer to the PI for review.
  • All potential caregivers will receive a follow-up phone call for second level exclusion from the trial when appropriate.

Trial locations and contacts

5 sites in 1 country.

5 sites in 1 country

United States5 sites
  • University of Alabama at Birmingham

    Birmingham, Alabama, 35294-2041

  • University of Tennessee Health Science Center

    Memphis, Tennessee, 38163

  • Stanford University and Veterans Affairs

    Menlo Park, California, 94025

  • University of Miami at Miami, Center on Adult Development and Aging

    Miami, Florida, 33136

  • Thomas Jefferson University at Philadelphia, Center for Applied Research on Aging and Health

    Philadelphia, Pennsylvania, 19107

Other trials in United States

About this study

Official title: Coordinating Center for Enhancing Alzheimer Disease and Related Disorder Caregiving

Established in 1995, Resources for Enhancing Alzheimer's Caregiver Health (REACH) is a unique, multi-site research program sponsored by the National Institute on Aging (NIA) and the National Institute on Nursing Research (NINR). The primary purpose of REACH is to carry out social and behavioral research on interventions designed to enhance family caregiving for Alzheimer's disease and related disorders. Specifically, REACH has two goals: to test the effectiveness of multiple different interventions and to evaluate the pooled effect of REACH interventions overall. REACH grew out of a National Institute of Health (NIH) initiative that acknowledged the well-documented burdens associated with family caregiving as well as the existence of promising family caregiver interventions reported in the literature.

Read the detailed description

Six sites (Boston, Birmingham, Memphis, Miami, Palo Alto, and Philadelphia) developed and evaluated a variety of multi-component interventions for family caregivers of persons with Alzheimer's Disease (AD) at the mild or moderate level of impairment. The multi-component interventions implemented across the six sites included: 1) Individual Information and Support strategies, 2) Group Support and Family Systems therapy, 3) Psychoeducational and Skill-based Training approaches, 4) Home-based Environmental interventions,, and 5) Enhanced Technology Support Systems. Although the interventions were derived from diverse theoretical models, they are all consistent with basic health-stress models in which the goal is to change the nature of specific stressors (e.g. problem behavior of the care recipient), their appraisal, and/or the caregivers response to the stressors. All of the REACH interventions were guided by detailed treatment manuals and certification procedures that assured that the interventions were delivered consistently over time at each site. Careful attention was also paid to the issue of treatment integrity. Different strategies were used at each site to induce and assess all three fundamental aspects of treatment integrity: delivery, receipt, and enactment (Burgio, et al., 2001). In addition, because the caregiving experience in race and ethnic minority families is particularly neglected in the field, there was a strong emphasis placed on the inclusion of African American and Hispanic caregivers. Thus, assessments as well as interventions were tailored at each site to meet the needs of culturally diverse racial/ethnic majority and minority populations.

All of the REACH sites shared several common goals, including: 1) designing theory-driven caregiving interventions to test hypotheses about intervention processes and their effect on family caregivers, 2) specifying intervention components that help us understand the pathways through which interventions produce desired outcomes, 3) developing a standardized outcome protocol to assess the impact of different strategies on caregivers and their care recipients within each site and across sites, and 4) creating a common database that would facilitate pooling data across sites. In addition, standard selection criteria were adopted by REACH.

Although REACH has some of the features of a traditional multi-site randomized controlled clinical trial (e.g., random assignment of participants to treatment and control conditions, common database and outcome measures, and identical measurement intervals across sites), it differs on one key dimension-the interventions varied across sites. REACH was designed to examine the feasibility and outcomes of multiple different intervention approaches, rather than to provide definitive information on the efficacy of one specific intervention strategy for enhancing caregiver outcomes. The strength of this approach is that it efficiently yields information about the effectiveness of different approaches to AD caregiving as well as the combined effects of active treatment versus controls, as reported in the planned meta-analysis.

REACH successfully randomized 1222 caregiver/care recipient dyads representing both majority and minority populations to 15 different conditions.

Being tested
Skill Training Condition - problem solving training, REACH for TLC (Telephone Linked Computer) system
Keywords
Family Caregivers, Dementia, Alzheimer Disease, Randomized Controlled Trial, Intervention Studies
Medical subject headings
Dementia, Alzheimer Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Skill Training Condition - problem solving trainingProcedure or surgery

  • REACH for TLC (Telephone Linked Computer) systemProcedure or surgery

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The outcomes were assessed 6 months after randomization and included a measure of burden and a measure of depression. Caregiver burden was assessed using the Revised Memory and Behavior Problem Checklist (RMBPC).

  2. Emotional distress was determined by the Center for Epidemiological Studies Depression Scale (CES-D) a global measure of depression.

Secondary outcomes (3)
  1. Long-term care placement of dementia patients and caregiver health and well-being

  2. Use of cognitive enhancement medication

  3. Clinical significance of caregiver interventions in diverse populations

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Sep 2005 (estimated)
  2. Study startSep 1996
  3. Study completionNov 2001

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
1,200 participants
IDs, dates and publications
ClinicalTrials.gov ID
NCT00178165
Sponsor's protocol ID
AG13305-01
Other IDs
NR13269, AG13313, AG13297, AG13289, AG13265, AG13255, AG13305
Status last verified
Sep 2005
First submitted
13 Sep 2005
Last updated
15 Sep 2005
Results posted
No

Publications

  • Belle SH, Czaja SJ, Schulz R, Zhang S, Burgio LD, Gitlin LN, Jones R, Mendelsohn AB, Ory MG; REACH Investigators. Using a new taxonomy to combine the uncombinable: integrating results across diverse interventions. Psychol Aging. 2003 Sep;18(3):396-405. doi: 10.1037/0882-7974.18.3.396.

    PubMed 14518803
  • Czaja SJ, Schulz R, Lee CC, Belle SH; REACH Investigators. A methodology for describing and decomposing complex psychosocial and behavioral interventions. Psychol Aging. 2003 Sep;18(3):385-95. doi: 10.1037/0882-7974.18.3.385.

    PubMed 14518802
  • Wisniewski SR, Belle SH, Coon DW, Marcus SM, Ory MG, Burgio LD, Burns R, Schulz R; REACH Investigators. The Resources for Enhancing Alzheimer's Caregiver Health (REACH): project design and baseline characteristics. Psychol Aging. 2003 Sep;18(3):375-84. doi: 10.1037/0882-7974.18.3.375.

    PubMed 14518801
  • Gitlin LN, Belle SH, Burgio LD, Czaja SJ, Mahoney D, Gallagher-Thompson D, Burns R, Hauck WW, Zhang S, Schulz R, Ory MG; REACH Investigators. Effect of multicomponent interventions on caregiver burden and depression: the REACH multisite initiative at 6-month follow-up. Psychol Aging. 2003 Sep;18(3):361-74. doi: 10.1037/0882-7974.18.3.361.

    PubMed 14518800
  • Schulz R, Belle SH, Czaja SJ, Gitlin LN, Wisniewski SR, Ory MG; REACH Investigators. Introduction to the special section on Resources for Enhancing Alzheimer's Caregiver Health (REACH). Psychol Aging. 2003 Sep;18(3):357-60. doi: 10.1037/0882-7974.18.3.357.

    PubMed 14518799
  • Gallagher-Thompson D, Coon DW, Solano N, Ambler C, Rabinowitz Y, Thompson LW. Change in indices of distress among Latino and Anglo female caregivers of elderly relatives with dementia: site-specific results from the REACH national collaborative study. Gerontologist. 2003 Aug;43(4):580-91. doi: 10.1093/geront/43.4.580.

    PubMed 12937336
  • Burgio L, Stevens A, Guy D, Roth DL, Haley WE. Impact of two psychosocial interventions on white and African American family caregivers of individuals with dementia. Gerontologist. 2003 Aug;43(4):568-79. doi: 10.1093/geront/43.4.568.

    PubMed 12937335
  • Mahoney DF, Tarlow BJ, Jones RN. Effects of an automated telephone support system on caregiver burden and anxiety: findings from the REACH for TLC intervention study. Gerontologist. 2003 Aug;43(4):556-67. doi: 10.1093/geront/43.4.556.

    PubMed 12937334
  • Burns R, Nichols LO, Martindale-Adams J, Graney MJ, Lummus A. Primary care interventions for dementia caregivers: 2-year outcomes from the REACH study. Gerontologist. 2003 Aug;43(4):547-55. doi: 10.1093/geront/43.4.547.

    PubMed 12937333
  • Gitlin LN, Winter L, Corcoran M, Dennis MP, Schinfeld S, Hauck WW. Effects of the home environmental skill-building program on the caregiver-care recipient dyad: 6-month outcomes from the Philadelphia REACH Initiative. Gerontologist. 2003 Aug;43(4):532-46. doi: 10.1093/geront/43.4.532.

    PubMed 12937332
  • Eisdorfer C, Czaja SJ, Loewenstein DA, Rubert MP, Arguelles S, Mitrani VB, Szapocznik J. The effect of a family therapy and technology-based intervention on caregiver depression. Gerontologist. 2003 Aug;43(4):521-31. doi: 10.1093/geront/43.4.521.

    PubMed 12937331
  • Schulz R, Burgio L, Burns R, Eisdorfer C, Gallagher-Thompson D, Gitlin LN, Mahoney DF. Resources for Enhancing Alzheimer's Caregiver Health (REACH): overview, site-specific outcomes, and future directions. Gerontologist. 2003 Aug;43(4):514-20. doi: 10.1093/geront/43.4.514. No abstract available.

    PubMed 12937330

Questions about this trial

What is this clinical trial studying?

A study testing Skill Training Condition - problem solving training and REACH for TLC (Telephone Linked Computer) system in people with Dementia and Alzheimer Disease, run by University of Pittsburgh at 5 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 11 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Sep 2005. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The outcomes were assessed 6 months after randomization and included a measure of burden and a measure of depression. Caregiver burden was assessed using the Revised Memory and Behavior Problem Checklist (RMBPC).. The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00178165, which also lists 12 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Sep 2005.

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Coordinating Center for Enhancing ADRD Caregiving | AzTrials