O'Connor C M, Clemson L, Brodaty H, Jeon Y H, Mioshi E, Gitlin L N
Ageing, Work & Health Research Unit, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia.
School of Psychiatry, University of New South Wales, Kensington, New South Wales, Australia.
Int Psychogeriatr. 2014 May;26(5):857-69. doi: 10.1017/S1041610214000040. Epub 2014 Feb 10.
Behavioral and psychological symptoms of dementia (BPSD) are often considered to be the greatest challenge in dementia care, leading to increased healthcare costs, caregiver burden, and placement into care facilities. With potential for pharmacological intervention to exacerbate behaviors or even lead to mortality, the development and rigorous testing of non-pharmacological interventions is vital. A pilot of the Tailored Activities Program (TAP) for reducing problem behaviors in people with dementia was conducted in the United States with promising results. This randomized trial will investigate the effectiveness of TAP for reducing the burden of BPSD on persons with dementia and family caregivers within an Australian population. This trial will also examine the cost-effectiveness and willingness to pay for TAP compared with a control group.
This randomized trial aims to recruit 180 participant dyads of a person with dementia and their caregivers. Participants will have a diagnosis of dementia, exhibit behaviors as scored by the Neuropsychiatric Inventory, and the caregiver must have at least 7 h per week contact. Participants will be randomly allocated to intervention (TAP) or control (phone-based education sessions) groups, both provided by a trained occupational therapist. Primary outcome measure will be the revised Neuropsychiatric Inventory - Clinician rating scale (NPI-C) to measure BPSD exhibited by the person with dementia.
This trial investigates the effectiveness and cost-effectiveness of TAP within an Australian population. Results will address a significant gap in the current Australian community-support base for people living with dementia and their caregivers.
痴呆症的行为和心理症状(BPSD)通常被认为是痴呆症护理中最大的挑战,会导致医疗成本增加、照顾者负担加重以及被安置到护理机构。由于药物干预有可能加剧行为问题甚至导致死亡,因此开发和严格测试非药物干预措施至关重要。美国开展了一项针对减少痴呆症患者问题行为的量身定制活动计划(TAP)试点,取得了可喜成果。这项随机试验将调查TAP在澳大利亚人群中减轻痴呆症患者和家庭照顾者BPSD负担的有效性。该试验还将研究与对照组相比,TAP的成本效益以及支付意愿。
这项随机试验旨在招募180对痴呆症患者及其照顾者作为参与者。参与者需被诊断为患有痴呆症,表现出神经精神科问卷所评分的行为,且照顾者每周至少有7小时的接触时间。参与者将被随机分配到干预组(TAP)或对照组(电话健康教育课程),两组均由经过培训的职业治疗师提供服务。主要结局指标将是修订后的神经精神科问卷临床医师评定量表(NPI-C),以测量痴呆症患者表现出的BPSD。
本试验研究了TAP在澳大利亚人群中的有效性和成本效益。研究结果将填补当前澳大利亚社区对痴呆症患者及其照顾者支持基础方面的重大空白。