Gallagher Virginia T, Arp Anna, Thompson Ryan, Rossetti Agustina, Patrie James, Reilly Shannon E, Manning Carol A
Department of Neurology, University of Virginia, Charlottesville, Virginia.
Brain Institute, University of Virginia, Charlottesville, Virginia.
medRxiv. 2024 Aug 16:2024.08.15.24312041. doi: 10.1101/2024.08.15.24312041.
Efficacy of the Individualized Coordination and Empowerment for Care Partners of Persons with Dementia (ICECaP), an intervention that involves one-on-one individualized support from a dementia care coordinator for a dementia care partner, compared to an active control group. At least once monthly contact is made from a dementia care coordinator to the dementia care partner by telephone, video conferencing, email, or in-person support at clinical visits for the person with dementia. In this pilot randomized unblinded control trial of ICECaP, n=61 (n=90 randomized) care partners completed 12-months of the ICECaP intervention and n=69 (n=92 randomized) care partners received routine clinical support (controls) in an outpatient memory care clinic at an academic medical center, from which the participants were recruited (ClinicalTrials.gov: NCT04495686, funded by Department of Defense and Virginia Department for Aging and Rehabilitative Services). Early termination endpoints (death and higher level of care) and trial drop out were comparable across groups. Primary efficacy outcomes were evaluated by comparing changes in care partner mental health, burden, and quality of life from baseline to 12-months between ICECaP and controls. Linear-mixed ANCOVA revealed no significant group differences in longitudinal changes on measures of caregiving burden, care partner depression, anxiety, quality of life, or reactions to the behavioral symptoms of the person with dementia. Hypothesized reasons for lack of initial efficacy on primary 12-month outcomes are discussed.
痴呆症患者护理伙伴个性化协调与赋能干预措施(ICECaP)的疗效研究。该干预措施包括痴呆症护理协调员为痴呆症患者的护理伙伴提供一对一的个性化支持,并与一个积极对照组进行比较。痴呆症护理协调员通过电话、视频会议、电子邮件或在痴呆症患者临床就诊时提供面对面支持,每月至少与痴呆症护理伙伴联系一次。在这项ICECaP的试点随机非盲对照试验中,61名(随机分组的90名中的)护理伙伴完成了为期12个月的ICECaP干预,69名(随机分组的92名中的)护理伙伴在一所学术医疗中心的门诊记忆护理诊所接受常规临床支持(对照组),参与者就是从该诊所招募的(ClinicalTrials.gov:NCT04495686,由国防部和弗吉尼亚州老龄与康复服务部资助)。早期终止终点(死亡和更高水平的护理)以及试验退出在各小组之间具有可比性。主要疗效结果通过比较ICECaP组和对照组从基线到12个月期间护理伙伴心理健康、负担和生活质量的变化来评估。线性混合协方差分析显示,在护理负担、护理伙伴抑郁、焦虑、生活质量或对痴呆症患者行为症状的反应等测量指标的纵向变化方面,各小组之间没有显著差异。文中讨论了在12个月主要结果上缺乏初始疗效的假设原因。