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非记忆主导型痴呆的更好生活:一项基于网络的护理者教育项目随机对照试验的研究方案(BELIDE试验)

Better Living with Non-memory-led Dementia: study protocol for a randomised controlled trial of a web-based caregiver educational programme (BELIDE trial).

作者信息

Suarez-Gonzalez Aida, Brotherhood Emilie, John Amber, Hayes Oliver, Rossi-Harries Sam, Zimmermann Nikki, Mansfield Valerie, Brand Andrew, Hoare Zoe, Fitzsimmons Deborah, Cullen Katherine, Crutch Sebastian, Stott Joshua

机构信息

Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK

Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK.

出版信息

BMJ Open. 2025 Sep 5;15(9):e102518. doi: 10.1136/bmjopen-2025-102518.

Abstract

INTRODUCTION

Carers of people with non-memory-led dementias such as posterior cortical atrophy (PCA), primary progressive aphasia (PPA) and behavioural variant frontotemporal dementia (bvFTD) face unique challenges. Yet, little evidence-based support and guidance are available for this population. To address this gap in services, we have developed a novel, web-based educational programme: the Better Living with Non-memory-led Dementia programme (BELIDE). BELIDE was co-designed with people with lived experience of non-memory-led dementia and a previous pilot study confirmed its feasibility as an online intervention. This protocol outlines the randomised controlled trial (RCT) to evaluate the clinical and cost-effectiveness of BELIDE.

METHODS AND ANALYSIS

This is a parallel-group, single-blind, RCT of 238 unpaid caregivers of people diagnosed with PCA, PPA or bvFTD recruited internationally among members of the UK-based organisation Rare Dementia Support. The intervention (BELIDE programme) consists of six structured online educational modules tailored to each phenotype, a virtual onboarding session, real-life practice tasks and up to two follow-up facilitation sessions. The group receiving the intervention will be given access to the programme, while the control group will receive treatment as usual and be placed on a wait-list to receive access to the programme once they complete their participation in the trial. The allocation ratio will be 1:1 stratified by dementia diagnosis and gender. The primary outcome is reduction in caregiver depressive symptoms. Secondary outcomes include stress, anxiety, self-efficacy, quality of life and caregiver-patient relationship quality. Data will be collected online via Qualtrics surveys at baseline, 8 weeks and 6 months post-randomisation. A mixed-method process evaluation with a subgroup of intervention participants will explore barriers and facilitators for engagement. A health economics evaluation will also be conducted to assess cost-effectiveness. If effective, this programme could improve access to caregiver support for non-memory-led dementias by providing scalable, tailored education.

ETHICS AND DISSEMINATION

Ethical approval has been granted by University College London Research Ethics Committee (8545/007). The results will be disseminated via peer-reviewed publications, conferences, stakeholder events and open-access resources.

TRIAL REGISTRATION

This trial has been registered prospectively on the Clinical Trials registry, first posted on 5 February 2024 under registration number NCT06241287.

摘要

引言

患有非记忆主导型痴呆症(如后皮质萎缩症(PCA)、原发性进行性失语症(PPA)和行为变异型额颞叶痴呆症(bvFTD))患者的照护者面临着独特的挑战。然而,针对这一群体的循证支持和指导却很少。为了填补服务中的这一空白,我们开发了一个全新的基于网络的教育项目:非记忆主导型痴呆症优质生活项目(BELIDE)。BELIDE是与有非记忆主导型痴呆症生活经历的人共同设计的,之前的一项试点研究证实了其作为在线干预措施的可行性。本方案概述了一项随机对照试验(RCT),以评估BELIDE的临床效果和成本效益。

方法与分析

这是一项平行组、单盲的随机对照试验,在英国组织罕见痴呆症支持组织的成员中,从国际上招募了238名被诊断患有PCA、PPA或bvFTD患者的无薪照护者。干预措施(BELIDE项目)包括六个针对每种表型量身定制的结构化在线教育模块、一次虚拟入职培训、现实生活实践任务以及最多两次后续促进会议。接受干预的组将可以使用该项目,而对照组将接受常规治疗,并被列入等待名单,一旦他们完成试验参与,就可以使用该项目。分配比例将按痴呆症诊断和性别进行1:1分层。主要结果是照护者抑郁症状的减轻。次要结果包括压力、焦虑、自我效能感、生活质量以及照护者与患者关系的质量。数据将通过Qualtrics调查在基线、随机分组后8周和6个月时在线收集。对一部分干预参与者进行的混合方法过程评估将探索参与的障碍和促进因素。还将进行健康经济学评估以评估成本效益。如果有效,该项目可以通过提供可扩展的、量身定制的教育,改善非记忆主导型痴呆症患者照护者获得支持的机会。

伦理与传播

伦敦大学学院研究伦理委员会已批准该研究(8545/007)。研究结果将通过同行评审出版物、会议、利益相关者活动和开放获取资源进行传播。

试验注册

该试验已在临床试验注册中心进行前瞻性注册,于2024年2月5日首次发布,注册号为NCT06241287。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c785/12414229/5f064fd97b82/bmjopen-15-9-g001.jpg

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