Enhanced Quality in Primary Care for Elders With Diabetes and Dementia

Enhanced Quality in Primary Care for Elders With Diabetes and Dementia

The purpose of this study is to develop and test a care quality improvement intervention featuring use of consensus decisional guidance for the medical management of diabetes (DM) in patients with Alzheimer's disease and related dementia (ADRD) in primary care, provider (PCP) workflow enhancements supported by a panel manager(PM) for workflow support, electronic health record (EHR) decision support and feedback, and PCP collaborative learning.

Inclusion Criteria:

• Patient must receive care at participating NYU FGP clinics.
• Patient must be English or Spanish speaking.
• Patient must have DM diagnosis.
• Patient must have documented cognitive impairment or an ADRD diagnosis.
• Patient must have someone who is identified as a family or friend who provides caregiving assistance.

Caregiver:

• Caregiver must have adequate knowledge of identified patient and/or participate in that member's healthcare decisions.
• Caregiver must be English or Spanish speaking.
• Caregiver must demonstrate capacity to consent to research participation.
• Caregiver must be at least 21 years old.

Exclusion Criteria:

Patient:

• Patient does not receive care at participating NYU FGP clinics.
• Patient is not 65 years and older.
• Patient is not English or Spanish speaking.
• Patient does not have DM diagnosis.
• Patient does not have documented Cognitive impairment or an ADRD diagnosis.
• Patient has severe dementia, other terminal illness with <6 months to live, and/or is hospice eligible.
• Patient does not have a caregiver.

Caregiver:

• Caregiver does not have adequate knowledge of identified patient and/or does not participate in that member's healthcare decisions.
• Caregiver is not English or Spanish speaking.
• Caregiver lacks capacity to consent to research.
• Caregiver is under 21 years old.