# Pragmatic Trial of the Effectiveness and Cost-Effectiveness of Dementia Care.

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2021 · $385,495

## Abstract

PROJECT SUMMARY
In the United States, an estimated 5.5 million persons are affected by Alzheimer's disease, the most common
type of dementia. The clinical manifestations of dementia are devastating and often lead to caregiver stress,
burnout, and medical illnesses. Dementia is a prototype of a disorder with complex needs that span both the
patient and caregiver, medical and social domains, and health system and community-based organizations.
In response, several dementia care programs have been developed to more comprehensively meet the needs
of patients and their caregivers, including those based within health care systems and those based in the
community. These programs have been implemented at either single sites or on a relatively small scale; none
has been replicated widely because of unanswered questions about effectiveness and cost-effectiveness.
In November 2017, the Patient Centered Outcomes Research Institute (PCORI) approved a 4-site pragmatic
clinical trial to compare the effectiveness of health-systems-based care (based on the UCLA Alzheimer's and
Dementia Care program) with community-based care (based on the Benjamin Rose Institute Care Consultation
program) on patient- and caregiver-reported outcome measures, including behavioral symptoms and caregiver
distress (co-primary outcomes), and secondary outcomes of caregiver strain, unmet needs, and depression
over 18-months. Because of PCORI's mandate, neither intervention will be compared to usual care (thus, only
relative effectiveness can be determined). Nor will cost-effectiveness of either intervention be evaluated.
The proposed research will add a third usual care (UC) arm and expand outcomes to include costs and health
care utilization. This expansion will permit comparison of each of the intervention arms to current usual care,
thereby providing multisite pragmatic randomized clinical trial evidence for effectiveness of the two active
treatment arms. It will also allow evaluation of whether paying for such care will offset the costs and
determination of which intervention is more cost effective. The study will also conduct exploratory analyses of
tertiary outcomes of both interventions versus usual care including mortality, time spent at home, long-term
nursing home placement, physician and patient/caregiver satisfaction and comparing all three groups on
several types of utilization and out-of-pocket expenses.
The study's questions are fundamental to planning for the clinical care of persons with dementia. They
address both clinical effectiveness and cost-effectiveness. By answering these questions, clinicians, health
systems, and insurers can make decisions about which programs to promote, scale and disseminate.

## Key facts

- **NIH application ID:** 10420646
- **Project number:** 3R01AG061078-03S1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** DAVID B. REUBEN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $385,495
- **Award type:** 3
- **Project period:** 2018-09-30 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10420646

## Citation

> US National Institutes of Health, RePORTER application 10420646, Pragmatic Trial of the Effectiveness and Cost-Effectiveness of Dementia Care. (3R01AG061078-03S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10420646. Licensed CC0.

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