A randomized trial of a web-based platform to help families manage dementia-related behavioral symptoms: The WeCareAdvisor™

Gitlin, Laura N.; Kales, Helen C.; Marx, Katherine; Stanislawski, Barbara

doi:10.1016/j.cct.2017.08.001

Cited by 16 publications

(9 citation statements)

References 45 publications

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“…The WeCareAdvisor, a web-based clinical research platform aimed at interventions for behavioral disturbances in in dementia, is being tested in a randomized trial. 25 The NIH will soon fund a clinical trials network and coordinating center for mobile cognitive trials (https://grants. nih.gov/grants/guide/rfa-files/RFA-AG-18-012.html).…”

Section: Cloud-based Analytic Platforms and Trial Network For Mobilementioning

confidence: 99%

Mobile and pervasive computing technologies and the future of Alzheimer’s clinical trials

2018

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The rapid growth of mobile phones, automated speech recognizing personal assistants, and internet access among the elderly provides new opportunities for incorporating such technologies into clinical research and personalized medical care. Alzheimer's disease is a good test case given the need for early detection, the high rate of clinical trial failures, the need to more efficiently recruit patients for trials, and the need for sensitive and ecologically valid trial outcomes.

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Section: Cloud-based Analytic Platforms and Trial Network For Mobilementioning

confidence: 99%

Mobile and pervasive computing technologies and the future of Alzheimer’s clinical trials

2018

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“…A two-site randomized controlled trial was conducted with one-month intervention and follow-up after baseline assessment targeting family caregivers of people with dementia. The design of the trial is detailed in a prior manuscript [ 30 ]. All three phases or the project were approved in 2012 by Institutional Review Boards of University of Michigan and Johns Hopkins University.…”

Section: Methodsmentioning

confidence: 99%

“…Secondary measures were chosen based upon those that are both meaningful in clinical practice as well as appear to be impacted by family caregiver interventions in prior trials [ 18 – 20 ]. For a full description of measures, please see the WeCareAdvisor protocol paper [ 30 ].…”

Section: Methodsmentioning

confidence: 99%

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Effect of the WeCareAdvisor™ on family caregiver outcomes in dementia: a pilot randomized controlled trial

et al. 2018

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BackgroundBehavioral and psychological symptoms of dementia (BPSD) are universal and associated with multiple negative outcomes. This pilot randomized controlled trial (RCT) evaluated the effect of using the WeCareAdvisor, an innovative web-based tool developed to enable family caregivers to assess, manage, and track BPSD.MethodsThis RCT enrolled 57 dementia family caregivers from community and clinical settings in Ann Arbor, Michigan and Baltimore, Maryland. Participants were randomly assigned to immediate use of the WeCareAdvisor tool (WCA, n = 27) or a Waitlist control group (n = 30) that received the tool after a one-month waiting period. Outcomes for the caregiver and the person they were caring for were assessed at baseline (T0) and one-month followup for both the WCA (T1) and Waitlist control (T2) groups.ResultsCaregiver mean age was 65.9 ± 14.0 years old. About half (49%) were spouses. Baseline characteristics were comparable between groups except for mean caregiver confidence which was higher in the control group (WCA 35.0 ± 10.0 vs. Waitlist control 39.7 ± 6.9, p = 0.04). There were no significant differences between the WCA and control groups in characteristics of the person with dementia. After their one-month of tool use (T1), WCA caregivers showed significant within group improvement in caregiver distress (− 6.08 ± 6.31 points, t = − 4.82, p < 0.0001) and behavioral frequency (− 3.60 ± 5.05, t = − 3.56, p = 0.002), severity (− 3.24 ± 3.87, t = − 4.19, p = 0.0003) and total behavioral score (− 6.80 ± 10.73, t = − 3.17, p = 004). In the same timeframe, Waitlist control caregivers showed a significant decrease in confidence (− 6.40 ± 10.30, t = − 3.40, p = 0.002). The WCA group showed greater improvement in distress compared to the Waitlist group (T0-T1; t = − 2.49, p = 0.02), which remained significant after adjusting for site and baseline distress. There were no significant between-group differences in caregiver confidence or other secondary outcomes. After their one month of tool use (T2), the Waitlist group also showed significant improvement in caregiver distress (− 3.72 ± 7.53, t = − 2.66, p = 0.013), stress (− 0.41 ± 1.02, t = − 2.19, p = 0.037), confidence (4.38 ± 5.17, t = 4.56, p < 0.0001), burden (− 2.76 ± 7.26, t = − 2.05, p = 0.05), negative communication (− 1.48 ± 2.96, t = − 2.70, p = 0.012) and behavioral frequency (− 1.86 ± 4.58, t = − 2.19, p = 0.037); distress remained significant after adjustment.ConclusionsIn this pilot RCT, WCA use resulted in a significant decrease in caregiver distress. Future research will identify whether longer use of WCA can impact other caregiver and behavioral outcomes.Trial registrationClinicaltrials.gov identifier NCT02420535 (Date of registry: 4/20/2015, prior to the start of the clinical trial).

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“…For each item, caregivers have to indicate the presence, the severity, and the extent of emotional distress that each symptom causes. Similar to Gitlin et al [69], we will add a frequency score and will ask caregivers how confident they are in managing a certain symptom on a 5-point Likert scale (0 = not confident to 4 = extremely confident).…”

Section: Methodsmentioning

confidence: 99%

Early recognition and treatment of neuropsychiatric symptoms to improve quality of life in early Alzheimer’s disease: protocol of the BEAT-IT study

Eikelboom

Singleton²,

Berg

et al. 2019

Alz Res Therapy

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Background Neuropsychiatric symptoms (NPS) are very common in patients with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) dementia and are associated with various disadvantageous clinical outcomes including a negative impact on quality of life, caregiver burden, and accelerated disease progression. Despite growing evidence of the efficacy of (non)pharmacological interventions to reduce these symptoms, NPS remain underrecognized and undertreated in memory clinics. The BEhavioural symptoms in Alzheimer’s disease Towards early Identification and Treatment (BEAT-IT) study is developed to (1) investigate the neurobiological etiology of NPS in AD and (2) study the effectiveness of the Describe, Investigate, Create, Evaluate (DICE) approach to structure and standardize the current care of NPS in AD. By means of the DICE method, we aim to improve the quality of life of AD patients with NPS and their caregivers who visit the memory clinic. This paper describes the protocol for the intervention study that incorporates the latter aim. Methods We aim to enroll a total of 150 community-dwelling patients with MCI or AD and their caregivers in two waves. First, we will recruit a control group who will receive care as usual. Next, the second wave of participants will undergo the DICE method. This approach consists of the following steps: (1) describe the context in which NPS occur, (2) investigate the possible causes, (3) create and implement a treatment plan, and (4) evaluate whether these interventions are effective. Primary outcomes are the quality of life of patients and their caregivers. Secondary outcomes include NPS change, caregiver burden, caregivers’ confidence managing NPS, psychotropic medication use, the experiences of patients and caregivers who underwent the DICE method, and the cost-effectiveness of the intervention. Conclusions This paper describes the protocol of an intervention study that is part of the BEAT-IT study and aims to improve current recognition and treatment of NPS in AD by structuring and standardizing the detection and treatment of NPS in AD using the DICE approach. Trial registration The trial was registered on the Netherlands Trial Registry ( NTR7459 ); registered 6 September 2018.

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A randomized trial of a web-based platform to help families manage dementia-related behavioral symptoms: The WeCareAdvisor™

Cited by 16 publications

References 45 publications

Mobile and pervasive computing technologies and the future of Alzheimer’s clinical trials

Mobile and pervasive computing technologies and the future of Alzheimer’s clinical trials

Effect of the WeCareAdvisor™ on family caregiver outcomes in dementia: a pilot randomized controlled trial

Early recognition and treatment of neuropsychiatric symptoms to improve quality of life in early Alzheimer’s disease: protocol of the BEAT-IT study

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