Volkmer A, Walton H, Swinburn K, Spector A, Warren J D, Beeke S
Division of Psychology and Language Sciences, University College London, London, UK.
Department of Applied Health Research, UCL, London, UK.
Pilot Feasibility Stud. 2023 May 23;9(1):87. doi: 10.1186/s40814-023-01301-6.
There has been a growing focus on functional communication interventions for primary progressive aphasia (PPA). These interventions aim to support individuals to participate in life situations. One such intervention, communication partner training (CPT) aims to change conversation behaviours in both the person with PPA and their communication partner (CP). CPT has a growing evidence base in stroke aphasia; however, these programmes are not designed to meet the needs of people with progressive communication difficulties. To address this, the authors developed a CPT program entitled Better Conversations with PPA (BCPPA) and undertook a pilot trial to establish for a future full trial; predicted recruitment rates, acceptability, an assessment of treatment fidelity and an appropriate primary outcome measure.
This was a single-blind, randomised controlled pilot study comparing BCPPA to no treatment, delivered across 11 National Health Service Trusts in the UK. A random sample of eight recordings of local collaborators delivering the intervention were analysed to examine fidelity. Participants completed feedback forms reporting on acceptability. Pre- and post-intervention measures targeted conversation behaviours, communication goals and quality of life.
Eighteen people with PPA and their CPs (9 randomised to BCPPA, 9 randomised to no treatment) completed the study. Participants in the intervention group rated BCPPA positively. Treatment fidelity was 87.2%. Twenty-nine of 30 intervention goals were achieved or over-achieved and 16 of 30 coded conversation behaviours demonstrated change in the intended direction. The Aphasia Impact Questionnaire was identified as the preferred outcome measure.
The first randomised controlled UK pilot study of a CPT program for people with PPA and their families demonstrates BCPPA is a promising intervention. The intervention was acceptable, treatment fidelity high and an appropriate measure identified. Results of this study indicate a future RCT of BCPPA is feasible.
Registered 28/02/2018 ISRCTN10148247 .
针对原发性进行性失语(PPA)的功能性沟通干预受到越来越多的关注。这些干预旨在帮助个体参与生活情境。其中一种干预方式,即沟通伙伴培训(CPT),旨在改变PPA患者及其沟通伙伴(CP)的对话行为。CPT在中风失语症方面的证据基础不断扩大;然而,这些方案并非为满足进行性沟通困难患者的需求而设计。为解决这一问题,作者开发了一个名为“与PPA更好对话”(BCPPA)的CPT项目,并进行了一项试点试验,为未来的全面试验确定预计招募率、可接受性、治疗保真度评估以及合适的主要结局指标。
这是一项单盲随机对照试点研究,将BCPPA与不治疗进行比较,在英国11个国民健康服务信托机构开展。随机抽取8份当地合作者实施干预的记录进行分析,以检查保真度。参与者填写反馈表报告可接受性。干预前后的测量指标针对对话行为、沟通目标和生活质量。
18名PPA患者及其CP(9人随机分配至BCPPA组,9人随机分配至不治疗组)完成了研究。干预组的参与者对BCPPA给予了积极评价。治疗保真度为87.2%。30个干预目标中有29个达成或超额达成,30个编码的对话行为中有16个朝着预期方向发生了变化。失语症影响问卷被确定为首选结局指标。
英国首个针对PPA患者及其家属的CPT项目的随机对照试点研究表明,BCPPA是一种有前景的干预措施。该干预可接受,治疗保真度高,且确定了合适的测量指标。本研究结果表明,未来对BCPPA进行随机对照试验是可行的。
于2018年2月28日注册,ISRCTN10148247 。