GRACE-Augmented Wellness Visits for Aging
(SPIRE2 Trial)
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial explores how adding the Geriatric Resources and Assessment for the Care of Elders (GRACE) program to regular wellness check-ups can improve health outcomes for older adults with complex health needs. The study tests two approaches: standard wellness visits and enhanced visits with the GRACE model. Researchers aim to determine if the enhanced visits can reduce hospitalizations and improve the lives of patients and caregivers. This trial may suit individuals aged 65 and older who have frequent health issues, are on Medicare, and live close enough to the practice for a home visit. As an unphased trial, this study offers a unique opportunity to contribute to innovative care strategies for older adults.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What prior data suggests that the GRACE model is safe for older adults?
Research has shown that the GRACE model, used in this study, is generally well-received by older adults. This method supports and manages care for seniors with complex health needs. Studies have found that it helps manage care with few reports of negative effects. The goal is to improve healthcare delivery and reduce unnecessary hospital visits, benefiting patient well-being. Although specific safety data for this study's use of GRACE is limited, its use in similar situations has not raised major safety concerns.12345
Why are researchers excited about this trial?
Researchers are excited about the GRACE-Augmented Wellness Visits for Aging because it aims to enhance the standard Annual Wellness Visits by incorporating Geriatric Resources and Assessment for the Care of Elders (GRACE). Unlike typical wellness visits that primarily focus on general health assessments, the GRACE model brings a more comprehensive approach by addressing the specific needs of older adults, particularly those at high risk. This involves a tailored plan that includes coordinated care and personalized interventions to better manage health conditions and improve quality of life. By integrating GRACE, there's potential for more effective management of complex geriatric issues, which could lead to better health outcomes for aging populations.
What evidence suggests that the AWV and AWV + GRACE interventions could be effective for improving outcomes in older adults with complex health needs?
Research has shown that the GRACE model, included in one of the treatment arms of this trial, can enhance care for older adults, particularly those with complex health needs. Studies have found that it improves the quality of care and health outcomes for low-income seniors. It manages care for patients with high needs while reducing healthcare costs over time. Some research suggests that the GRACE model is cost-neutral, meaning it does not add extra costs while improving care. Overall, the GRACE model has been linked to better care and increased independence for seniors. In this trial, participants will receive either Annual Wellness Visits (AWV) alone or AWV combined with the GRACE model to assess its impact.12356
Are You a Good Fit for This Trial?
This trial is for older adults with complex health needs who could benefit from preventive and palliative care. It aims to improve their well-being and reduce hospital visits. Participants should be eligible for Annual Wellness Visits (AWVs) but cannot already be receiving GRACE services.Inclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants receive Annual Wellness Visits (AWV) or AWV augmented by GRACE intervention
Follow-up
Participants are monitored for safety and effectiveness after treatment
Long-term Follow-up
Monitoring of exploratory geriatric outcomes and hospitalizations
What Are the Treatments Tested in This Trial?
Interventions
- Geriatric Resources and Assessment for the Care of Elders
Trial Overview
The study compares regular AWVs with AWVs enhanced by the GRACE model, which adds geriatric resources and assessments. The goal is to see if this combination can better support high-need older adults.
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
Active Control
Randomize 16 practices to AWV+GRACE and assess impact on the population deemed by study algorithm as high-risk and recruit 90 participants from each practice (n=90/practice) to complete surveys prior to the intervention and 18 months later.
Randomize 16 practices to AWV and assess impact on the population deemed by study algorithm as high-risk and recruit 90 participants from each practice (n=90/practice) to complete surveys prior to the intervention and 18 months later.
Find a Clinic Near You
Who Is Running the Clinical Trial?
Massachusetts General Hospital
Lead Sponsor
Indiana University School of Medicine
Collaborator
Patient-Centered Outcomes Research Institute
Collaborator
Baylor Scott and White Health
Collaborator
Griffin Hospital
Collaborator
Brandeis University
Collaborator
Dartmouth-Hitchcock Medical Center
Collaborator
Atrium Health Wake Forest Baptist
Collaborator
Atrium Health Wake Forest Baptist
Collaborator
Citations
Effectiveness of the VA‐Geriatric Resources for Assessment ...
We compared outcomes among patients who received VA‐GRACE services after discharge and a control group of Veterans who were potentially ...
2.
agsjournals.onlinelibrary.wiley.com
agsjournals.onlinelibrary.wiley.com/doi/10.1111/j.1532-5415.2006.00791.xGeriatric Resources for Assessment and Care of Elders ...
The Geriatric Resources for Assessment and Care of Elders (GRACE) model of primary care was developed to improve the quality of care for low- ...
3.
commonwealthfund.org
commonwealthfund.org/publications/case-study/2021/oct/living-independently-graceLiving Independently with GRACE
The GRACE model helps primary care practices provide geriatric care management for high-need, high-cost patients while reducing costs over time.
Geriatric Resources for Assessment and Care of Elders ...
The GRACE model has been shown to improve quality of care and health outcomes in low-income seniors. It has also recently been shown to be cost neutral from the ...
a new model of primary care for low-income seniors - PubMed
The Geriatric Resources for Assessment and Care of Elders (GRACE) model of primary care for low-income seniors and their primary care physicians (PCPs)
Study Details | NCT06287801 | Annual Wellness Visits vs ...
This study consists of three aims focused on examining the feasibility of adding the Geriatric Resources and Assessment for the Care of Elders (GRACE) model ...
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