Study protocol: Randomised controlled trial to evaluate the impact of an educational programme on Alzheimer’s disease patients’ quality of life

Villars, H.; Gardette, Virginie; Perrin, Amélie; Hein, C.; Elmalem, Sophie; Peretti, Eva de; Zueras, Audrey; Vellas, Bruno; Nourhashémi, Fati

doi:10.1186/s13195-014-0066-1

Cited by 3 publications

(5 citation statements)

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“…Investigators and raters were blinded to group allocation. Details of the study protocol have been published previously [ 29 ].…”

Section: Methodsmentioning

confidence: 99%

“…Each session aimed to develop the caregivers’ understanding of their relatives’ illness (knowledge about the disease, crisis management of distressing or disruptive BPSD) and coping strategies (e.g. to adapt the communication style in stressful situations, strategies to find resources and a general understanding of care pathways) [ 29 , 33 ]. The content used pedagogic methods and tools (storytelling, brainstorming, drawings, videos, quizzes) [ 34 ] designed to be reproducible.…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2021

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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.

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“…Investigators and raters were blinded to group allocation. Details of the study protocol have been published previously [ 29 ].…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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

et al. 2021

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“…Information on some other important factors such as family representation, financial resources, caregiver comorbidities or distance to NH was not available. Secondly, the study was primarily designed to assess the impact of an educational intervention on the QOL of people with AD and not to study time to their NHP 9 . However, since we observed numerous NHPs in the first year of follow‐up, we then decided to collect more data to this effect by following our cohort for one more year.…”

Section: Discussionmentioning

confidence: 99%

“…Secondly, the study was primarily designed to assess the impact of an educational intervention the QOL of people with AD and not to study time to their NHP. 9 However, since we observed numerous NHPs in the first year of followup, we then decided to collect more data to this effect by following our cohort for one more year.…”

Section: Discussionmentioning

confidence: 99%

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

Villars

Gardette

Frayssignes

et al. 2022

Int J Geriat Psychiatry

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Objectives: Nursing Home Placement (NHP) can prove to be the only solution to some dead-end situations in Alzheimer's disease (AD). The predictors of NHP are known and can be related to either the person with dementia or his/her caregiver.We aimed to identify predictors of NHP among people with AD over a 2-year follow-up period, with a particular interest in the modifiable predictors, notably those involving caregivers. Methods:We studied data from the THERAD study, a French monocentric randomized controlled trial, involving 196 community-dwelling dyads, primarily assessing an educational intervention in AD. We performed a bivariate analysis followed by a multivariate Cox model, with a backward stepwise procedure. Results:The mean age of the patients was 82 years old, 67.7% were women and 56.9% were living with a partner. The mean age of the caregivers was 65.8 years old, 64.6% were women and half were spouses of the patients with a moderate burden.During the follow-up, 23 patients died and 49 were institutionalized. The majority of NHPs occurred during the first year (35 NHP). The mean time to NHP was 27.77 months after the diagnosis. Five independent predictors of NHP were found: a higher patient education level (aHR 6.31; CI95% = 1.88-21.22), a high caregiver Burden (aHR 3.97; CI95% = 1.33-11.85), the caregiver being the offspring of the patient (aHR 2.92; CI95% = 1.43-5.95), loss of autonomy (aHR 2.75; CI95% = 1.13-6.65) and disinhibition as a behavioural and psychological symptoms of dementia (BPSD) (aHR 2.38; CI95% = 1.26-4.47). Conclusions:Our data are in accordance with the literature in identifying loss of autonomy, burden and BPSD (disinhibition) as risk factors of NHP. We also found high patient education level and status of offspring caregiver as additional factors. It is essential to take into account the caregiver status when designing psychoeducational trials aiming to delay NHP. Further studies need to take into accountThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Dementia, End of Life, and Euthanasia: A Survey Among Dementia Specialists Organized by the Belgian Dementia Council

Picard

Bier

Capron

et al. 2019

JAD

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Background: Palliative care and Advance Care Planning (ACP) are increasingly recommended for an optimal management of late-stage dementia. In Belgium, euthanasia has been decriminalized in 2002 for patients who are "mentally competent" (interpreted as non-demented). It has been suggested that advance directives for euthanasia (ADE) should be made possible for dementia patients. Objective: This study presents the results of an internet survey among Belgian dementia specialists.

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Study protocol: Randomised controlled trial to evaluate the impact of an educational programme on Alzheimer’s disease patients’ quality of life

Cited by 3 publications

References 60 publications

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

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

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

Dementia, End of Life, and Euthanasia: A Survey Among Dementia Specialists Organized by the Belgian Dementia Council

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