Department of Medicine, Indiana University School of Medicine, 1101 West 10th Street, Indianapolis, IN, 46202, USA.
Division of General Internal Medicine and Geriatrics, Indianapolis, USA.
Trials. 2020 Apr 19;21(1):340. doi: 10.1186/s13063-020-4199-1.
Patients with Alzheimer's disease and related dementias (ADRD) and traumatic brain injury (TBI) and their caregivers require cognitive and behavioral symptom management, interdisciplinary care, support for caregivers, and seamless care coordination between providers. Caring for someone with ADRD or TBI is associated with higher rates of psychological morbidity and burden, social isolation, financial hardship, and deterioration of physical health. Tremendous need exists for primary care-based interventions that concurrently address the care needs of dyads and aim to improve care and outcomes for both individuals with ADRD and TBI and their family caregivers.
The Aging Brain Care Acquiring New Skills While Enhancing Remaining Strengths (ABC ANSWERS) study is a randomized controlled trial that tests the effectiveness of an intervention based on two evidence-based programs that have been developed for and previously tested in populations with ADRD, TBI, stroke, and late-life depression and/or who have survived an intensive care unit stay. This study includes 200 dyads comprised of a veteran with a diagnosis of ADRD or TBI and the veteran's primary informal caregiver. Dyads are randomized to receive the ABC ANSWERS intervention or routine Veterans Health Administration (VHA) primary care with a standardized educational and resource information packet. Data collection occurs at baseline and three follow-up time points (3 months, 6 months, and 12 months). The primary outcome is caregiver quality of life (QoL). A secondary measure for the caregiver is caregiver burden. Secondary measures for both the veteran and caregiver include symptoms of depression and anxiety.
The ABC ANSWERS intervention integrates common features of an evidence-based collaborative care model for brain health while concurrently attending to the implementation barriers of delivering care and skills to dyads. We hypothesize that caregivers in dyads randomized to the ABC ANSWERS program will experience higher levels of QoL and lower levels of depression, anxiety, dyadic strain, and caregiver burden at 12 months than those receiving usual VHA primary care.
ClinicalTrials.gov, NCT03397667. Registered on 12 January 2018.
患有阿尔茨海默病和相关痴呆症（ADRD）以及创伤性脑损伤（TBI）的患者及其护理人员需要认知和行为症状管理、跨学科护理、护理人员支持以及提供者之间无缝的护理协调。照顾患有 ADRD 或 TBI 的人会导致更高的心理发病率和负担、社会孤立、经济困难以及身体健康恶化。非常需要基于初级保健的干预措施，这些干预措施同时满足对双体护理的需求，并旨在改善患有 ADRD 和 TBI 的个体以及他们的家庭护理人员的护理和结果。
衰老大脑护理获取新技能同时增强剩余力量（ABC ANSWERS）研究是一项随机对照试验，测试了一种干预措施的有效性，该干预措施基于两个已为患有 ADRD、TBI、中风和老年期抑郁症的人群开发并经过先前测试的循证计划，或曾在重症监护病房接受过治疗。本研究包括 200 对由患有 ADRD 或 TBI 的退伍军人和退伍军人的主要非正式护理人员组成的双体。双体随机接受 ABC ANSWERS 干预或常规退伍军人健康管理局（VHA）初级保健，并提供标准化的教育和资源信息包。数据收集在基线和三个随访时间点（3 个月、6 个月和 12 个月）进行。主要结果是护理人员的生活质量（QoL）。护理人员的次要衡量标准是护理人员负担。退伍军人和护理人员的次要衡量标准包括抑郁和焦虑症状。
ABC ANSWERS 干预措施整合了脑健康循证协作护理模式的常见特征，同时关注向双体提供护理和技能的实施障碍。我们假设，与接受常规 VHA 初级保健的双体相比，随机分配到 ABC ANSWERS 计划的双体中的护理人员在 12 个月时将体验到更高水平的 QoL 和更低水平的抑郁、焦虑、双体紧张和护理人员负担。
ClinicalTrials.gov，NCT03397667。于 2018 年 1 月 12 日注册。
