# STAR Caregivers - Virtual Training and Follow-up

> **NIH NIH R01** · KAISER FOUNDATION RESEARCH INSTITUTE · 2021 · $509,815

## Abstract

ABSTRACT
Alzheimer's Disease and related Dementias (ADRD) are debilitating conditions affecting more than 5 million
Americans in 2014. It is projected that 8.4 million people with be diagnosed with ADRD over the next 15 years
and health care costs attributable to ADRD are projected to be more than $1.2 trillion by 2050. Behavioral and
Psychological Symptoms of Dementia (BPSD) are common and often involve aggressive behavior towards
family caregivers (CG) in response to unmet needs, discomfort, or frustration. BPSD frequently lead to CG
seeking medication to control patient symptoms. Antipsychotic use in persons with dementia (PWD) more than
doubles mortality risk. The Choosing Wisely Guidelines from the American Psychiatric Association and
American Geriatrics Society both recommend against prescribing antipsychotics as a first-line treatment for
BPSD. Behavioral interventions such as STAR-Caregivers are efficacious first-line treatments for managing
BPSD endorsed by the Administration on Aging. However, the programs have not been implemented widely –
partly due to the intensity/cost of the programs and difficulty conducting outreach. No study has investigated
CG willingness to reduce or discontinue antipsychotic use. We propose a Stage III clinical trial to ascertain the
feasibility and acceptability of STAR Virtual Training and Follow-up (STAR- VTF) in which (a) training materials
are delivered electronically and learning is self-directed, (b) caregivers have two in-home visits with a social
worker and (c) where caregivers receive support from a social worker via secure messaging (email) within a
web-based portal. We will compare outcomes in the STAR-VTF group to an attention control group (mailed
material plus generic secure messages). Our specific aims are: (1) Assess the feasibility and acceptability of
STAR-VTF to caregivers; (2) Assess the feasibility and acceptability of the program from the payer
perspective; and (3) Test the hypotheses that (H1) caregiver participants in STAR-VTF will have lower levels of
caregiver burden at 8 weeks and 6 months compared to an attention control group; and (H2) PWD participants
in STAR-VTF will have lower rates of daily antipsychotic medication use at 6 months compared to attention
control. We propose to recruit 100 CG-PWD dyads (50 in each arm). This will be the first study to test a low
intensity, self-directed caregiver training program with secure message support from social workers. It will also
be the first study to measure changes in antipsychotic medication use by PWD after CG training. The study is
also innovative because it brings together leading experts in caregiver training, health information
management, and care management. Third, this will be the first study to use automated data and natural
language processing to identify potential caregivers in need of education/support at a time when antipsychotic
medication use begins. Results of this study will inform a future multi-site trial in the ...

## Key facts

- **NIH application ID:** 10200658
- **Project number:** 5R01AG061926-04
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Robert B. Penfold
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $509,815
- **Award type:** 5
- **Project period:** 2018-09-30 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10200658

## Citation

> US National Institutes of Health, RePORTER application 10200658, STAR Caregivers - Virtual Training and Follow-up (5R01AG061926-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10200658. Licensed CC0.

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