Specific Care and Assistance Plan for Alzheimer's Disease

NCT ID: NCT00480220

Last Updated: 2015-08-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

1200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-08-31

Study Completion Date

2007-08-31

Brief Summary

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The main objective of this work is to assess the feasibility and efficacy of a specific Care and Assistance Plan for Alzheimer's disease (PLASA). The main outcome measure selected is incapacity in carrying out the basic activities of daily living, evaluated by the ADCS-ADL scale .

The PLASA was developed by a working group appointed by the Direction Générale de la Santé as part of the government programme of action on Alzheimer's disease (October 2001, Ministère de l'Emploi et de la Solidarité).

Detailed Description

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It is estimated that at the present time about 50% of dependence in the elderly is related to dementias. Alzheimer's disease is the most common of these, and there are 100 000 new cases in France every year (Girard Report). Very often, once the diagnosis has been established these persons do not receive regular, codified follow-up, whereas Alzheimer's disease is a chronic disease which progresses over several years and leads to a variety of complications which must be identified and managed.

The main objective of this work is to assess the feasibility and efficacy of a specific Care and Assistance Plan for Alzheimer's disease (PLASA). The main outcome measure selected is incapacity in carrying out the basic activities of daily living, evaluated by the ADCS-ADL scale .

The PLASA was developed by a working group appointed by the Direction Générale de la Santé as part of the government programme of action on Alzheimer's disease (October 2001, Ministère de l'Emploi et de la Solidarité).

Methods The multicentre prospective study will be randomised within each centre. Study population: 1200 patients will be recruited in 20 French university hospitals and 40 general hospitals.

Inclusion criteria: Patients presenting mild to moderate Alzheimer's disease diagnosed by the NINCDS-ADRDA criteria (MMSE between 12 and 26), living at home and with an identified principal caregiver.

Randomisation and patient follow-up: After randomisation within each centre (specialised department of the university or general hospital), half of the patients will be managed according to the PLASA (group A). The other patients will receive the usual management of the centres (group B).

The PLASA includes detailed evaluation of the patient's cognitive and non-cognitive function, regular and standardised follow-up, management of complications and the setting up of assistance and support services according to common guidelines. As part of the PLASA, patients will be systematically seen in consultation every six months.

Data collection: In group A, data will be collected during six-monthly consultations for the duration of the study (T0, T6, T12, T18, T24). In group B, data will be collected during consultations at T0, T12 and T24. The coordinating centre (Toulouse) will contact every 6 months (T6, T12, T18, T24), by post or by telephone, the principal caregiver for collection of intermediate data in both groups. These data include evaluation of activities of daily living (ADCS-ADL), utilization of support and care services (RUD ), as well as subjective assessment of disease severity (ADCS-CGIC ). The patient's quality of life will also be evaluated in both groups at T0, T12 and T24.

Statistical analysis: 1200 subjects are needed to reveal a 30% decrease in incapacities in activities of daily living in the group of patients followed according to the PLASA.

Bivariate analysis will be carried out using the standard tests for this type of study (chi-squared test and Student's t test). The efficacy of the PLASA will be assessed by multivariate analysis, taking potential confounders into account.

Expected results: This project should contribute to better long-term management of patients with Alzheimer's disease and should reduce the burden on families.

Conditions

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Alzheimer's Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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1

Specific Intervention as Global care and support program

Group Type EXPERIMENTAL

Global care and support program

Intervention Type PROCEDURE

2

'No specific intervention'

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Global care and support program

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* patient seen in consultation in one of the centres participating in the study
* patient with probable or possible AD according to NINCDS-ADRDA criteria
* patient with an MMSE score between 12 and 26 (mild to moderate disease)
* patient capable of understanding and responding to the evaluations made
* patient who is not confined to bed or chair
* patient living at home with an informal caregiver
* informed consent of the patient (or legal representative) and of the caregiver agreeing to take part in the study.

Exclusion Criteria

* patient with an MMSE score of less than 12 or over 26
* patient incapable of understanding and responding to the evaluations made
* patient confined to bed or chair
* patient living at home without an informal carer or in an institution
* patient with a concomitant disorder threatening the vital prognosis at two years
* patient with a dementia other than AD
* patient already included in another research programme.
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Toulouse

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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VELLAS Bruno, PD PhD

Role: STUDY_DIRECTOR

University Hospital, Toulouse

Locations

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Hospital

Albi, , France

Site Status

Hospital Center

Alès, , France

Site Status

University Hospital

Angers, , France

Site Status

Hospital

Annecy, , France

Site Status

Hospital Center

Bar-le-Duc, , France

Site Status

University Hospital

Brest, , France

Site Status

Hospital Center

Carcassonne, , France

Site Status

Service de Gérontologie

Carvin, , France

Site Status

Hospital

Chambéry, , France

Site Status

Georges Clémenceau Hospital

Champcueil, , France

Site Status

Hospital Center

Grasse, , France

Site Status

University Hospital

Grenoble, , France

Site Status

Hôpital Charles Foix - La Triade

Ivry-sur-Seine, , France

Site Status

Hospital Center

Lannemezan, , France

Site Status

Hospital Center

Lavaur, , France

Site Status

Hospital

Lens, , France

Site Status

University Hospital

Lille, , France

Site Status

Hospital Center

Louviers, , France

Site Status

University Hospital

Lyon, , France

Site Status

University Hospital Sainte Marguerite

Marseille, , France

Site Status

University Hospital

Montpellier, , France

Site Status

University Hospital

Nice, , France

Site Status

Hospital Center

Niort, , France

Site Status

University Hospital

Nîmes, , France

Site Status

Hospital Bichat - Claude Bernard

Paris, , France

Site Status

Hospital Center Notre Dame du Bon Secours

Paris, , France

Site Status

University Hospital BROCA - La Rochefoucauld

Paris, , France

Site Status

University Hospital Pitié-Salpétrière

Paris, , France

Site Status

University Hospital Sainte Perrine

Paris, , France

Site Status

Hospital center

Plaisir, , France

Site Status

University Hospital

Reims, , France

Site Status

Hospital Center

Roubaix, , France

Site Status

University Hospital

Rouen, , France

Site Status

Hospital Center

Saint-Dizier, , France

Site Status

Hospital Center

Sézanne, , France

Site Status

University Hospital, Hôpital Xavier Arnozan

Toulouse, , France

Site Status

University Hospital

Toulouse, , France

Site Status

Hospital

Valenciennes, , France

Site Status

Hospital Center

Villejuif, , France

Site Status

Hospital

Wasquehal, , France

Site Status

Countries

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France

References

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Callahan CM, Boustani MA, Unverzagt FW, Austrom MG, Damush TM, Perkins AJ, Fultz BA, Hui SL, Counsell SR, Hendrie HC. Effectiveness of collaborative care for older adults with Alzheimer disease in primary care: a randomized controlled trial. JAMA. 2006 May 10;295(18):2148-57. doi: 10.1001/jama.295.18.2148.

Reference Type BACKGROUND
PMID: 16684985 (View on PubMed)

Teri L, Gibbons LE, McCurry SM, Logsdon RG, Buchner DM, Barlow WE, Kukull WA, LaCroix AZ, McCormick W, Larson EB. Exercise plus behavioral management in patients with Alzheimer disease: a randomized controlled trial. JAMA. 2003 Oct 15;290(15):2015-22. doi: 10.1001/jama.290.15.2015.

Reference Type BACKGROUND
PMID: 14559955 (View on PubMed)

Teri L, Logsdon RG, McCurry SM. Nonpharmacologic treatment of behavioral disturbance in dementia. Med Clin North Am. 2002 May;86(3):641-56, viii. doi: 10.1016/s0025-7125(02)00006-8.

Reference Type BACKGROUND
PMID: 12168563 (View on PubMed)

Vickrey BG, Mittman BS, Connor KI, Pearson ML, Della Penna RD, Ganiats TG, Demonte RW Jr, Chodosh J, Cui X, Vassar S, Duan N, Lee M. The effect of a disease management intervention on quality and outcomes of dementia care: a randomized, controlled trial. Ann Intern Med. 2006 Nov 21;145(10):713-26. doi: 10.7326/0003-4819-145-10-200611210-00004.

Reference Type BACKGROUND
PMID: 17116916 (View on PubMed)

Nourhashemi F, Andrieu S, Gillette-Guyonnet S, Giraudeau B, Cantet C, Coley N, Vellas B; PLASA Group. Effectiveness of a specific care plan in patients with Alzheimer's disease: cluster randomised trial (PLASA study). BMJ. 2010 Jun 3;340:c2466. doi: 10.1136/bmj.c2466.

Reference Type DERIVED
PMID: 20522656 (View on PubMed)

Nourhashemi F, Gillette-Guyonnet S, Andrieu S, Rolland Y, Ousset PJ, Vellas B; PLASA group. A randomized trial of the impact of a specific care plan in 1120 Alzheimer's patients (PLASA Study) over a two-year period: design and baseline data. J Nutr Health Aging. 2008 Apr;12(4):263-71. doi: 10.1007/BF02982632.

Reference Type DERIVED
PMID: 18373036 (View on PubMed)

Other Identifiers

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PHRC

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

0200601

Identifier Type: -

Identifier Source: org_study_id

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