Results  81 papers were reviewed 55 papers psychoeducational interventions 19 papers educational interventions 14 papers multicomponent interventions.

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Presentation transcript:

Results  81 papers were reviewed 55 papers psychoeducational interventions 19 papers educational interventions 14 papers multicomponent interventions. Most studies were of fair/moderate methodological quality.  Dementia is a progressive degenerative neurological disease with no known cure.  Day-to-day responsibility of caring for a person with dementia is often undertaken by a family member or friend.  Major issues faced by carers of people with dementia include: Psychological distress (depression and anxiety, lower self-efficacy, feelings of entrapment and guilt); Physical strain, fatigue, burnout; Poor coping skills, social isolation and lack of support; Legal and financial matters; Communication, safety and organisation in the home.  Psychoeducation, skill-building programmes and multi-component interventions, that include active participation of carers and care recipients, produce the most significant results for carers.  Benefits include: increased caregiver knowledge; reduced stress and depression levels; increased coping ability; increased self-efficacy; delayed residential care placement. Results (continued) Conclusions  Overall, interventions for carers of people with dementia were effective across a number of carer-related symptoms, but less so for patient-related symptoms. Contact Information: Despina Laparidou, Research Assistant, Tel: Dr Jo Middlemass, Lead Researcher, Tel:  Most commonly reported patient outcomes Frequency and severity of behavioural problems; cognitive status; institutionalisation rates; quality of life (QoL); depression.  Most commonly reported carer outcomes Burden; depression; self-efficacy; knowledge around dementia; reactions to patients’ cognitive, functional and behavioural problems; QoL; well-being; stress/distress.  Psychoeducational interventions Successful in improving carer-related outcomes, such as depression, burden, self- efficacy and knowledge, but less successful in improving patient-related outcomes, such as QoL, functional and behavioural problems, and institutionalisation.  Educational interventions Successful in improving most carer and patient related outcomes, except for carer depression, care recipient symptomatology and institutionalisation.  Multi-component interventions Effective across various outcomes, but produced mixed results for care recipient institutionalisation.  Cost-effectiveness One study reported that psychoeducational interventions for carers of people with dementia were not cost-effective; 1 study showed that a multi-component study alleviated some costs of caregiving; a systematic review reached no conclusion. Method  Eligibility criteria Participants included the main informal (unpaid) carers of community-dwelling people with early stages of dementia and their care recipient. Studies included psychoeducational, educational and multi-component interventions; reporting patient and carer outcomes, such as self-efficacy, institutionalisation, burden, depression, etc. [Research Question (RQ) 1]; reporting effectiveness (RQ2) and/or the cost effectiveness of interventions (RQ3).  Information sources Electronic searches performed in 17 databases from inception to November Reference lists from articles identified were scanned and, whenever necessary, authors of missing studies were contacted to obtain full- text articles.  Study selection Initially titles and abstracts were screened (by 2 independent reviewers) for relevance to the review, whereas final eligibility was assessed through full-text screening against the inclusion criteria using a pre-designed study selection form (based on PICO).  Data extraction and synthesis Data were extracted independently by two review authors, using a specifically designed data extraction form based on National Institute for Health and Clinical Excellence (NICE) public health guidance. Due to study heterogeneity a quantitative meta-analysis was not feasible or appropriate, so a narrative synthesis was performed.  Risk of bias/quality assessment of studies Methodological quality of included studies was assessed (by 2 independent reviewers) based on the quality criteria for critical appraisal proposed by the NICE public health guidance and the Systematic Evidence Reviews & Clinical Practice Guidelines proposed by the National Heart, Lung and Blood Institute at the National Institutes of Health. Aim We aimed to systematically review literature on interventions to improve outcomes for carers and people with dementia to inform development of a complex psychoeducational intervention to improve quality of life and outcomes for carers and patients with early dementia. Research Questions 1.What psychoeducational interventions have been found to be effective for carers of people with dementia and how effective are they? 2.What psychoeducational interventions have been found to be cost effective for carers of people with dementia and how cost-effective are they? 3.What patient and carer outcomes have been identified/measured in studies of psychoeducational interventions for carers of people with dementia? Background Potentially relevant articles remaining: n= 731 Articles excluded based on title & abstract screening: n= 588 Potentially relevant articles, selected for full- text screening: n= 143 Articles identified through searches: n= 823 Duplicates excluded: n= 92 Articles excluded based on inclusion criteria: n= 62 Articles included in final review: n= 81  More cost-effectiveness studies are needed – evidence suggests a lack of data on cost-effectiveness of current interventions for carers of people with dementia.