The CASCADE Study

• Research type

  Research Study

• Full title

  CASCADE: CASe finding in hospitals - impacts on CAre for people with DEmentia

• IRAS ID

  181831

• Contact name

  Jane Fleming

• Contact email

  jane.fleming@phpc.cam.ac.uk

• Sponsor organisation

  Cambridge University Hospitals NHS Foundation Trust and the University of Cambridge

• Clinicaltrials.gov Identifier

  609/M/C/1469, University of Cambridge Insurance Office; HSK/SF/UH/02005, University of Hertfordshire Health and Human Sciences Ethics Committee with Delegated Authority

• Duration of Study in the UK

  1 years, 10 months, 31 days

• Research summary

  Background
  In 2012 hospitals across England introduced measures to ensure that all people aged 75 and over with an unplanned hospital admission were assessed for dementia (known as case-finding). The overall aims of this study are to explore the impact of this in-hospital case finding on patients and family carers and to see if patients identified as needing further assessment subsequently receive further investigations leading to a diagnosis of dementia and further services. We also want to describe the different methods for dementia case-finding being used in hospitals in the East of England (EoE).

  Methods
  There are 3 phases to the research.

  Phase 1: To understand current approaches to dementia case-finding in EoE we will:
  • Review publicly available policy documents and statistics about case-finding in the EoE
  • Undertake interviews with hospital staff involved in case-finding
  • Undertake interviews with GPs to get their views on the impacts of case-finding

  Phase 2: To understand the impacts of dementia case-finding on patients and family carers we will:
  • Undertake semi-structured interviews with
  a) older people (aged ≥75) who underwent case-finding during an unplanned hospital admission 6-12 months previously and whose GPs were advised to re-assess and, if appropriate, refer them for further investigation because of concerns about their cognition identified in hospital
  b) ≥75-year-olds who took part in a previous clinical evaluation of Addenbrooke's Hospital's dementia case-finding process during unplanned admissions 2 years ago
  • Interviews with family carers of both a) and b)

  Phase 3: To understand the impact of dementia case-finding on health and social care services we will:
  • Describe case-studies tracking patient service use pathways after discharge from hospital
  • Construct a set of typical scenarios for potential service use for different dementia case-finding outcomes
  • Calculate ‘indicative’ costs of various care scenarios.

  The project is funded by CLAHRC EoE for 22 months. It will be guided by an advisory group and a user reference group.

• REC name

  South Central - Oxford C Research Ethics Committee

• REC reference

  15/SC/0728

• Date of REC Opinion

  1 Feb 2016

• REC opinion

  Further Information Favourable Opinion