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NCT02213458

Care Ecosystem: Navigating Patients and Families Through Stages of Care

Completed NA Results posted Last updated 20 February 2024
What this trial tests

NA trial testing Navigated Care in Dementia in 1,560 participants. Completed in 8 March 2018.

Timeline
20 March 2015
Primary endpoint
8 March 2018
8 March 2018

Quick facts

Lead sponsorUniversity of California, San Francisco
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingsingle
Primary purposesupportive care
Enrollment1,560
Start date20 March 2015
Primary completion8 March 2018
Estimated completion8 March 2018
Sites2 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

University of California, San Francisco

Who can join

45 and older, any sex, with Dementia or Alzheimer Disease. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Quality of Life-Alzheimer's Disease, Change From Baseline to 1 Year Primary · Baseline to one year

An established 13-item measure, with a 1-4 ordinal scale for each item, to obtain a rating of the patient's quality of life from the caregiver. Item scores are summed for a total score ranging from 13-52, with higher scores representing better quality of life

GroupValue95% CI
Navigated Care-1.43± 5.64
Survey of Care-1.12± 5.87
Change in Caregiver Reported Rate of Emergency Department Utilization: Baseline to One Year Secondary · Baseline to one year

Health care utilization based upon caregiver survey to assess emergency department, hospitalization, and ambulance use rates. To be confirmed using Medicare claims data.

GroupValue95% CI
Navigated Care.0483± .703
Survey of Care.175± .840
Change in Caregiver Burden, Baseline to One Year Secondary · Baseline to one year

Zarit Burden Interview (short version). An established 12-item measure, with a 0-4 ordinal scale for each item, to measure caregiver burden. Item scores are summed for a total score ranging from 0-48, with higher scores representing higher levels of burden.

GroupValue95% CI
Navigated Care-1.682± 8.144
Survey of Care-1.482± 8.641
Satisfaction With Dementia Care Secondary · One year

A novel 1-item measure, with a 1-5 ordinal scale, to measure caregiver satisfaction with dementia care provided by the patient's clinical team. Also, one question asking caregivers whether they would recommend the Care Ecosystem to another caregiver. Collected in the treatment group only.

GroupValue95% CI
Navigated Care148
Navigated Care107
Navigated Care57
Navigated Care9
Change in Caregiver Depression, Baseline to One Year Secondary · Baseline to one year

Patient Health Questionnaire 9 (PHQ-9). Higher scores represent more severe depression. Scores range from 0-27.

GroupValue95% CI
Navigated Care-0.831± 4.312
Survey of Care-0.238± 4.053
Change in Caregiver Self-efficacy, Baseline to One Year Secondary · Baseline to one year

A novel 4-item measure on a 1-5 ordinal scale to measure self-efficacy around dementia caregiving. Higher scores represent greater self-efficacy. Scores range from 5-15.

GroupValue95% CI
Navigated Care1.356± 3.038
Survey of Care1.043± 2.647

Adverse events — posted to ClinicalTrials.gov

Time frame: 1 year. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Navigated Care
Serious: 269/1024 (26%)
Deaths: 74/1024
Survey of Care
Serious: 143/536 (27%)
Deaths: 39/536

Serious adverse events (2 terms)

ReactionSystemNavigated CareSurvey of Care
Overnight hospitalizationGeneral disorders
Severe fallGeneral disorders

Most-reported serious reactions: Overnight hospitalization, Severe fall.

Data from ClinicalTrials.gov NCT02213458 adverse events section.

Sponsor's own description

This is a randomized clinical trial evaluating the benefits of a program that supports model care for persons with dementia and their family caregivers. Subjects were recruited from California, Nebraska and Iowa. Subjects determined to be eligible were consented and randomized into one of two groups. Two thirds of patients were enrolled into Navigated Care that provided them with assistance in meeting important benchmarks in their care, for example completion of legal and financial planning and strategies for minimizing caregiver burden. One third of patients were enrolled to a control group, entitled Survey of Care. Outcomes include quality of life, health care utilization, caregiver burden, satisfaction with care, caregiver depression, and caregiver self-efficacy.

Publications & conference data

6 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Effect of Collaborative Dementia Care via Telephone and Internet on Quality of Life, Caregiver Well-being, and Health Care Use: The Care Ecosystem Randomized Clinical Trial.
    Possin KL, Merrilees JJ, Dulaney S, Bonasera SJ, et al · · 2019 · cited 199× · PMID 31566651 · DOI 10.1001/jamainternmed.2019.4101
  2. Remotely delivered information, training and support for informal caregivers of people with dementia.
    González-Fraile E, Ballesteros J, Rueda JR, Santos-Zorrozúa B, et al · · 2021 · cited 54× · PMID 33417236 · DOI 10.1002/14651858.cd006440.pub3
  3. Care Ecosystem Collaborative Model and Health Care Costs in Medicare Beneficiaries With Dementia: A Secondary Analysis of a Randomized Clinical Trial.
    Guterman EL, Kiekhofer RE, Wood AJ, Allen IE, et al · · 2023 · cited 20× · PMID 37721734 · DOI 10.1001/jamainternmed.2023.4764
  4. Effect of collaborative dementia care on potentially inappropriate medication use: Outcomes from the Care Ecosystem randomized clinical trial.
    Liu AK, Possin KL, Cook KM, Lynch S, et al · · 2023 · cited 17× · PMID 36331050 · DOI 10.1002/alz.12808
  5. The Effect of the Care Ecosystem Collaborative Care Model on End-of-Life Outcomes for People With Dementia and Their Caregivers.
    Hunt LJ, Harrison KL, Kiekhofer R, Merrilees J, et al · · 2025 · PMID 40827842 · DOI 10.1177/10499091251367311
  6. The Long‐Term Effects of the Care Ecosystem Dementia Care Management Program on Quality of Life and Caregiver Well‐being
    Possin K, Dulaney S, Wood A, Bonasera S, et al · · 2024

Verify or expand the search:

Other trials of Navigated Care

Trials testing the same drug.

Other recruiting trials for Dementia

Currently open trials in the same condition.

Other University of California, San Francisco trials

Trials by the same sponsor.

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Data sources for this page

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Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing