Effects of telehealth intervention for people with dementia and their carers: A systematic review and meta‐analysis of randomized controlled studies

Abstract

Purpose Interventions delivered using telehealth modalities are becoming standard practice with patient populations around the world, partly because of innovation necessitated by the COVID‐19 pandemic and partly due to improved infrastructure and comfort of providers, patients, and families, through technology. Though increasingly utilized, the effectiveness of telehealth interventions with families with dementia remains unclear. This gives rise to the need for investigation to develop telehealth interventions that are evidence based and not merely convenient tools. This current study is designed to systematically examine the impact and effectiveness of telehealth‐delivered psychoeducational and behavioral interventions among persons with dementia and their caregivers. Design The design combines systematic review and meta‐analysis. Methods A total of eight databases were electronically accessed and searched as of November 16, 2021. Experimental studies identifying the results of telehealth interventions for persons with dementia and associated caregivers published in English have been reviewed in this study. Standardized mean differences (SMD) offering 95% confidence intervals (CI) were developed to pool the effect size using a random effects model (in this case, Stata 16.0). The Revised Cochrane Risk‐of‐Bias Tool for Randomized Trials (RoB‐2) was used to analyze the study's methodological soundness. Findings Nineteen cases met the eligibility criteria (including 1379 persons with dementia and 1339 caregivers). Overall, telehealth interventions demonstrated effects in the expected directions on depression (SMD −0.63; 95% degree of confidence intervals (CI) −0.88 to −0.38, p < 0.001); and caregivers' perceived competency (SMD 0.27; 95% CI −0.05 to 0.50, p = 0.02). There were, however, no statistically significant effects observed on cognitive function or multiple aspects of quality of life for subjects. Conclusions Telehealth interventions appear to effect a reduction in depression among persons diagnosed with dementia while improving the perceived competency of caregivers. Clinical Relevance The study's results could be used as evidence of the effectiveness of using telehealth for persons with dementia and their caregivers, including contextualizing where they are used (i.e., long‐term care facilities, private homes, etc.), understanding the mechanisms in play (including intervention delivery and systems), and isolating and identifying mediating influences.

2023 Alzheimer's disease facts and figures

“…This care model has successfully operated for over a decade in an Indianapolis health care system 563 . Other efforts have attempted to broaden the reach and accessibility of interventions for dementia caregivers through the use of technologies (for instance, video‐phone delivery and online training), 564–572 while others have disseminated evidence‐based dementia care interventions into community‐based programs and health care systems 560,573,574 …”

“…Adult day programs in many states were interrupted or closed. These and other factors shaped by the COVID‐19 pandemic have caused emotional distress and other negative outcomes among caregivers 572,616 . In addition, staff and directors of adult day service programs in the United States reported perceived declines in cognition, function and wellbeing among clients due to state closures during the pandemic.…”

“…Other efforts have attempted to broaden the reach and accessibility of interventions for dementia caregivers through the use of technologies (for instance, video-phone delivery and online training),[564][565][566][567][568][569][570][571][572] while others have disseminated evidence-based dementia care interventions into community-based programs and health care systems 560,573,574. Because caregivers and the settings in which they provide care are diverse, more studies are required to define which interventions are most effective for specific situations or care transitions and how these interventions are successful [575][576][577][578][579].…”

Effects of technology‐assisted interventions for people with dementia: A systematic review and meta‐analysis

“…telehealth) offer significant promise as effective, low‐cost, and easily accessible methods. Moreover, telehealth appears to benefit people with dementia and their caregivers by enhancing continuity of care and addressing numerous care requirements remotely (Saragih et al, 2022).…”

A Pilot Study of Remote Use of a Life Storybook Intervention Involving Family Members of Persons with Dementia

“…These factors may have significant negative impact on the cognitive function, behavioral and psychological symptoms, and quality of life of persons with dementia living at home or in institutions [3,4]. To cope with this situation, the use of everyday digital technologies to provide remote support for persons with dementia and their caregivers is being investigated worldwide [5,6].…”