Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jul;68 Suppl 2(Suppl 2):S1-S7.
doi: 10.1111/jgs.16621.

Embedded Pragmatic Trials in Dementia Care: Realizing the Vision of the NIA IMPACT Collaboratory

Susan L Mitchell  1   2 , Vincent Mor  3   4 , Jill Harrison  3 , Ellen P McCarthy  1   2
Affiliations

Embedded Pragmatic Trials in Dementia Care: Realizing the Vision of the NIA IMPACT Collaboratory

Susan L Mitchell et al. J Am Geriatr Soc. 2020 Jul.

Abstract

Close to 6 million Americans have Alzheimer's disease (AD) or Alzheimer's disease and related dementia (AD/ADRD). These high-need, high-cost patients are vulnerable to receiving poor quality uncoordinated care, ultimately leading to adverse health outcomes, poor quality of life, and misuse of resources. Improving the care of persons living with dementia (PLWD) and their caregivers is an urgent public health challenge that must be informed by high-quality evidence. Although prior research has elucidated opportunities to improve AD/ADRD care, the adoption of promising interventions has been stymied by the lack of research evaluating their effectiveness when implemented under real-world conditions. Embedded pragmatic clinical trials (ePCTs) in healthcare systems have the potential to accelerate the translation of evidence-based interventions into clinical practice. Building from the foundation of the National Institutes of Healthcare Systems Collaboratory, in September 2019 the National Institute on Aging Imbedded Pragmatic AD/ADRD Clinical Trials (IMPACT) Collaboratory was launched. Its mission is to build the nation's capacity to conduct ePCTs within healthcare systems for PLWD and their caregivers by (1) developing and disseminating best practice research methods, (2) supporting the design and conduct of ePCTs including pilot studies, (3) building investigator capacity through training and knowledge generation, (4) catalyzing collaboration among stakeholders, and (5) ensuring the research includes culturally tailored interventions for people from diverse backgrounds. This report presents the rationale, structure, key activities, and markers of success for the overall NIA IMPACT Collaboratory. The articles that follow in this special Issue describe the specific work of its 10 core working groups and teams. J Am Geriatr Soc 68:S1-S7, 2020.

Keywords: clinical trial; dementia; healthcare systems; pragmatic.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: Vincent Mor chairs the Scientific Advisory Committee for naviHealth, a post-acute care convener serving hospitals and Medicare Advantage plans, a role for which he is compensated.

Figures

Figure 1.
Figure 1.
The mission, vision, and values of the National Institute on Aging Imbedded Pragmatic Alzheimer’s disease (AD) or an AD-related dementia (AD/ADRD) Clinical Trials (IMPACT) Collaboratory.
Figure 2.
Figure 2.
The organizational structure of the National Institute on Aging (NIA) Imbedded Pragmatic Alzheimer’s disease (AD) or an AD-related dementia (AD/ADRD) Clinical Trials (IMPACT) Collaboratory.
See this image and copyright information in PMC

References

    1. Alzheimer’s Association. 2019 Alzheimer’s disease facts and figures. https://www.alz.org/media/documents/alzheimers-facts-and-figures-2019-r.pdf. Accessed June 4, 2020
    1. Jutkowitz E, Kane RL, Gaugler JE, MacLehose RF, Dowd B, Kuntz KM. Societal and family lifetime cost of dementia: implications for policy. J Am Geriatr Soc. 2017;65:2169–2175. - PMC - PubMed
    1. Hebert LE, Weuve J, Scherr PA, Evans DA. Alzheimer disease in the United States (2010–2050) estimated using the 2010 census. Neurology. 2013;80:1778–1783. - PMC - PubMed
    1. Mitchell SL, Black BS, Ersek M, et al. Advanced dementia: state of the art and priorities for the next decade. Ann Intern Med. 2012;156:45–51. - PMC - PubMed
    1. Mitchell SL, Mor V, Gozalo PL, Servadio JL, Teno JM. Tube feeding in US nursing home residents with advanced dementia, 2000–2014. JAMA. 2016; 316:769–770. - PMC - PubMed

Publication types