Impact of an educational programme on Alzheimer’s disease patients’ quality of life: results of the randomized controlled trial THERAD

Abstract

Background Although educational interventions are recommended in Alzheimer’s disease (AD), studies assessing the impact of interventions such as “therapeutic patient education” are scarce. Indeed, the intrinsic nature of the disease is considered a barrier to patients’ involvement in such approaches. We aimed to evaluate an intervention by using a “dyadic” approach (patient and caregiver) in both intervention and assessment. Methods THERAD is a monocentric, randomized, controlled trial assessing the effects of a 2-month educational programme in mild to moderately severe AD patients among 98 dyads (caregiver/patient) on caregiver-reported patient quality of life (QOL) at 2 months. Community-dwelling patients and their caregivers were recruited in ambulatory units of the French Toulouse University Hospital. Self-reported patient QOL, autonomy, behavioural and psychological symptoms and caregiver QOL and burden were collected at 2, 6 and 12 months. Linear mixed models were used in modified intention-to-treat populations. We also performed sensitivity analysis. Results A total of 196 dyads were included, 98 in each group. The mean age of the patients was 82 years, 67.7% were women, diagnosed with AD (+/- cerebrovascular component) (mean MMSE =17.6), and 56.9% lived with a partner. The mean age of the caregivers was 65.7 years, and 64.6% were women (52.3% offspring/42.6% spouses), with a moderate burden (mean Zarit score = 30.9). The mean caregiver-reported patient QOL was lower than the self-reported QOL (28.61 vs. 33.96). We did not identify any significant difference in caregiver-reported patients’ QOL (p = 0.297) at 2 months, but there was a significant difference in self-reported patients’ QOL at 2 months (p = 0.0483) or 6 months (p = 0.0154). No significant difference was found for the secondary outcomes. The results were stable in the sensitivity analyses. Conclusions This randomized controlled trial assessing an educational intervention in 196 dyads (Alzheimer’s disease affected patient/caregiver) highlights the need to better consider the patient’s point of view, since only the self-reported QOL was improved. Additional studies using this dyadic approach are necessary in targeted subpopulations of caregivers (spouse vs. child, gender) and of patients (severity of cognitive impairment or behavioural disturbances) Trial registration THERAD study NCT01796314. Registered on February 19, 2013.

Effect of Coping Strategies Program on Quality of Life and Burden of Care Among Family Caregivers of Alzheimer Patients

“…This result is in the same line as, Villars, et al, (2021), who concluded that age, marital status, educational level,and occupational status are highly associated and related tothe total quality of life of the caregivers of Alzheimer's patients. Furthermore, the findings were confusing in that there was a statistically highly significant difference in the stress evaluation between caring relatives' work status and annual income in the preprogram period.…”

“…Burden and Quality of Life in Patients Diagnosed with Alzheimer's Disease", concluded that education in the program reduced the burden of care for caregivers of Alzheimer's patients and had a positive impact on their quality of life.This finding contradicts Villars, et al, (2021), who highlight the impact of educational programs on Alzheimer's patients' quality of life, although the results of randomized controlled studies do not support this claim. After two months, therapeutic patient education had a substantial effect on nurse-reported patient QOL, but not on self-reported patient QOL.…”

Burden Assessment and Quality of Life Among Caregivers for Alzheimer’s Patients

“…Results of the concurrent study showed that there was a highly statistically significant difference between the age of the caregivers and their quality of life. From the researcher's point of view, these findings donate the effectiveness of personal characteristics of the caregivers particularly age which is the basics of life and affect strongly on their quality of life.This result came in the same line with, Villars, et al (2021), who concluded that age, marital status, educational level, and occupational status are highly associated and related tothe total quality of life of the caregivers of Alzheimer's patients.…”

Predictors of nursing home placement at 2 years in Alzheimer's disease: A follow‐up survey from the THERAD study

“…The study protocol has been detailed elsewhere, 9 and the results recently published. 10 The participants were 196 community-dwelling people with mild to moderately severe AD 11 and their caregivers (196 dyads, 98 in each group) recruited in the geriatric department of the Toulouse Hospital between 2013 and 2015. The intervention was composed of individual sessions (for patients and caregivers) and group sessions (caregivers only).…”