Feedback System Analysis of a Multicomponent Intervention on Dyads of Home-Dwelling Persons With Dementia and Their Caregivers: Results From the LIVE@Home.Path Trial.

Complex intervention Complex systems Informal care Resource utilization Steady-state error

Journal

Innovation in aging
ISSN: 2399-5300
Titre abrégé: Innov Aging
Pays: England
ID NLM: 101703706

Informations de publication

Date de publication:
2024
Historique:
received: 27 01 2023
medline: 29 3 2024
pubmed: 29 3 2024
entrez: 29 3 2024
Statut: epublish

Résumé

Proper symptom management, informal caregiver support, and service innovation are required to reduce dementia care burden. The objective of this study is to investigate the effect of the multicomponent LIVE (Learning, Innovation, Volunteering, Empowerment) intervention on caregiver experience of the self-perceived care situation, coordinator performance, and informal care time. We conducted a 24-month multicomponent, stepped-wedge randomized control trial including dyads of people ≥65 years with mild-to-moderate dementia with minimum weekly contact with their informal caregivers in Norway. The intervention was implemented by municipal coordinators over a 6-month period. This study investigates the first 6-month period (September 2019-March 2020) of the trial, due to the coronavirus disease 2019 (COVID-19) pandemic. Primary outcomes are changes in provision of informal care time assessed by Resource Utilization in Dementia Care (RUD) and informal caregiver experience assessed by the Clinical Global Impression of Change (CGIC). We use logistic regression and feedback system analysis to assess the reach of the multicomponent intervention. A total of 280 dyads were included at baseline, mean age of the person with dementia was 81.8 years, and 62.5% were female. After 6 months, the feedback system analysis reveals that the caregivers randomized to the intervention period reported improved caregiver situation (CGIG-T: intervention 0.63 ( Findings illustrate the usefulness of dementia care coordinators that provide regular follow-up. We also show that complex intervention studies benefit from applying feedback system analysis. Meeting the needs of persons with dementia and their caregivers is a complex process that requires coordinated input from health services and user communities. NCT04043364.

Sections du résumé

Background and Objectives UNASSIGNED
Proper symptom management, informal caregiver support, and service innovation are required to reduce dementia care burden. The objective of this study is to investigate the effect of the multicomponent LIVE (Learning, Innovation, Volunteering, Empowerment) intervention on caregiver experience of the self-perceived care situation, coordinator performance, and informal care time.
Research Design and Methods UNASSIGNED
We conducted a 24-month multicomponent, stepped-wedge randomized control trial including dyads of people ≥65 years with mild-to-moderate dementia with minimum weekly contact with their informal caregivers in Norway. The intervention was implemented by municipal coordinators over a 6-month period. This study investigates the first 6-month period (September 2019-March 2020) of the trial, due to the coronavirus disease 2019 (COVID-19) pandemic. Primary outcomes are changes in provision of informal care time assessed by Resource Utilization in Dementia Care (RUD) and informal caregiver experience assessed by the Clinical Global Impression of Change (CGIC). We use logistic regression and feedback system analysis to assess the reach of the multicomponent intervention.
Results UNASSIGNED
A total of 280 dyads were included at baseline, mean age of the person with dementia was 81.8 years, and 62.5% were female. After 6 months, the feedback system analysis reveals that the caregivers randomized to the intervention period reported improved caregiver situation (CGIG-T: intervention 0.63 (
Discussion and Implications UNASSIGNED
Findings illustrate the usefulness of dementia care coordinators that provide regular follow-up. We also show that complex intervention studies benefit from applying feedback system analysis. Meeting the needs of persons with dementia and their caregivers is a complex process that requires coordinated input from health services and user communities.
Clinical Trial Registration Number UNASSIGNED
NCT04043364.

Identifiants

pubmed: 38550899
doi: 10.1093/geroni/igae020
pii: igae020
pmc: PMC10976912
doi:

Banques de données

ClinicalTrials.gov
['NCT04043364']

Types de publication

Journal Article

Langues

eng

Pagination

igae020

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America.

Déclaration de conflit d'intérêts

None.

Auteurs

Maarja Vislapuu (M)

Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Hordaland, Norway.

Monica Patrascu (M)

Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Hordaland, Norway.
Complex Systems Laboratory, Department of Automatic Control and Systems Engineering, University Politehnica of Bucharest, Bucharest, Romania.

Heather Allore (H)

Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA.

Bettina S Husebo (BS)

Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Hordaland, Norway.
Neuro-SysMed Center, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Hordaland, Norway.

Egil Kjerstad (E)

Department of Health and Social Sciences, NORCE Norwegian Research Centre AS, Bergen, Hordaland, Norway.

Marie H Gedde (MH)

Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Hordaland, Norway.
Haraldsplass Deaconess Hospital, Bergen, Norway.

Line I Berge (LI)

Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Hordaland, Norway.
NKS Olaviken Gerontopsychiatric Hospital, Askøy, Norway.

Classifications MeSH