Dr. Halima Amjad is an Assistant Professor of Medicine and practicing geriatrician with clinical expertise in Alzheimer's disease and related dementias at the Johns Hopkins University School of Medicine. Her long-term career goal is to become a leader in patient-oriented research that informs and improves medical care for older adults with dementia through the development and implementation of care delivery interventions in clinical practice. This award will ensure she has the knowledge, skills, and experience to develop effective interventions, lead clinical trials, and translate research findings into routine clinical care. The career development plan proposes five years of informal and formal training in mixed methods research, intervention development and testing including clinical trials, and implementation science focused on Alzheimer's disease and related dementias. Dr. Amjad has convened an outstanding mentorship team with expertise in the relevant research methods, dementia care, primary care, and care for complex older adults. The proposal will take place in a rich scientific environment with the resources necessary to support her research, career development, and transition to independent clinical investigation. Despite the growing burden of dementia on patients, families, and health systems, the majority of older adults with dementia receive suboptimal care for dementia after diagnosis. Clinical practice guidelines for dementia care are available, but are not widely known or consistently followed. Recent health systems changes, including new Medicare reimbursement mechanisms and uptake of electronic medical records (EMRs), present opportunities to improve post-diagnosis care for dementia in busy primary care settings. The proposal leverages these opportunities to address the complex challenges of clinical practice transformation and linking diagnosis to timely, high quality dementia care.
Aims 1 and 2 use a mixed methods approach (primary care provider and multidisciplinary staff surveys and interviews, patient and family interviews) to understand barriers and facilitators to post-diagnosis dementia care, key stakeholder perspectives on essential components and strategies for dementia care, and perceived feasibility of a comprehensive, multidisciplinary post-diagnosis dementia care intervention. Results will inform the adaptation of an intervention centered around a structured post-diagnosis dementia care visit in primary care in Aim 3. Implementation will leverage EMRs and Medicare reimbursement for dementia care to bring dementia-related assessment and support tools to primary care. Feasibility and acceptability of the intervention will be tested in one primary care clinic, laying the groundwork for a future multisite pragmatic randomized controlled trial to assess intervention effectiveness in improving quality of care and patient outcomes. The proposal addresses a significant challenge (dementia care) in an important setting (primary care). It will lead to an intervention that can be widely implemented and a clinical investigator poised to transform medical care for persons living with dementia.
Timely management of dementia remains a challenge for primary care providers despite their central role in the care of patients with dementia. The goal of this proposal is to adapt and implement a practical intervention to facilitate high quality, comprehensive post-diagnosis care for dementia in traditional primary care settings. The proposal will support the career development of Dr. Halima Amjad who aims to develop practical patient- and clinician-centered strategies to improve the care of older adults with dementia.
