Technology-Driven Interventions for Caregivers of Persons With Dementia

Godwin, Kyler M.; Mills, Whitney L.; Anderson, Jane; Kunik, Mark E.

doi:10.1177/1533317513481091

Cited by 160 publications

(147 citation statements)

References 27 publications

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“…Narrative syntheses showed positive intervention effects for anxiety in Godwin et al 22 focusing on the Caregiver's Friend and REACH interventions (number of studies unclear, no quality reported); and McKechnie et al 28 after computer-mediated interventions (two studies of high quality). Quantitative syntheses showed statistically significant positive intervention effects for anxiety in Vernooij-Dassen et al 31 following cognitive reframing interventions (four studies, all of which had some methodological limitations).…”

Section: Anxietymentioning

confidence: 99%

“…Similarly, in Macleod et al, 45 risk of bias was reported to have been assessed, but the results of this were not presented. Two reviews 22,34 did not perform any quality assessment of primary studies.…”

Section: Quality Of the Primary Studiesmentioning

confidence: 99%

“…[19][20][21][22][23][24][25][27][28][29][30][31][32][33][34][35][37][38][39][40][41][42][43]45,46 Mental health was variably defined (when reported). The terms depression, anxiety, psychological distress and self-efficacy were commonly used.…”

Section: Mental Healthmentioning

confidence: 99%

“…Of the reviews, 14 [19][20][21][22][23][24][25][26][27][28][29][30][31][32] focused on interventions for carers of people with dementia, four [33][34][35][36] focused on carers of people with cancer, four [37][38][39][40][41] focused on carers of people with stroke, three [42][43][44] focused on carers of people with various conditions at the end of life and two 45,46 focused on carers of people with mental health problems. Not all reviews reported the geographic location of the included primary studies.…”

Section: Overview Of the High-quality Reviewsmentioning

confidence: 99%

“…The multicomponent nature of many interventions meant that it was difficult to identify causal relationships. Eleven reviews undertook narrative synthesis 19,[21][22][23]28,32,35,36,[43][44][45] and six undertook quantitative synthesis. 20,26,27,29,30,34 Ten reviews 24,25,31,33,[37][38][39][40][41][42]46 contributed both narrative and quantitative syntheses.…”

Section: Approach To Synthesismentioning

confidence: 99%

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Updated meta-review of evidence on support for carers

Thomas

Dalton

Harden

et al. 2017

Health Serv Deliv Res

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BackgroundPolicy and research interest in carers continues to grow. A previous meta-review, published in 2010, by Parkeret al.(Parker G, Arksey H, Harden M.Meta-review of International Evidence on Interventions to Support Carers. York: Social Policy Research Unit, University of York; 2010) found little compelling evidence of effectiveness about specific interventions and costs.ObjectiveTo update what is known about effective interventions to support carers of ill, disabled or older adults.DesignRapid meta-review.SettingAny relevant to the UK health and social care system.ParticipantsCarers (who provide support on an unpaid basis) of adults who are ill, disabled or older.InterventionsAny intervention primarily aimed at carers.Main outcome measuresAny direct outcome for carers.Data sourcesDatabase searches (including Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, MEDLINE, Applied Social Sciences Index and Abstracts and Social Care Online) for systematic reviews published from January 2009 to 2016.Review methodsWe used EndNote X7.4 (Thomson Reuters, CA, USA) to screen titles and abstracts. Final decisions on the inclusion of papers were made by two reviewers independently, using a Microsoft Excel®2013 spreadsheet (Microsoft Corporation, Redmond, WA, USA). We carried out a narrative synthesis structured by patient condition and by seven outcomes of interest. We assessed the quality of the included systematic reviews using established criteria. We invited a user group of carers to give their views on the overall findings of our review.ResultsSixty-one systematic reviews were included (27 of high quality, 25 of medium quality and nine of low quality). Patterns in the literature were similar to those in earlier work. The quality of reviews had improved, but primary studies remained limited in quality and quantity. Of the high-quality reviews, 14 focused on carers of people with dementia, four focused on carers of those with cancer, four focused on carers of people with stroke, three focused on carers of those at the end of life with various conditions and two focused on carers of people with mental health problems. Multicomponent interventions featured prominently, emphasising psychosocial or psychoeducational content, education and training. Multiple outcomes were explored, primarily in mental health, burden and stress, and well-being or quality of life. Negative effects following respite care were unsupported by our user group. As with earlier work, we found little evidence on intervention cost-effectiveness. No differences in review topics were found across high-, medium- and low-quality reviews.LimitationsThe nature of meta-reviews precludes definitive conclusions about intervention effectiveness, for whom and why. Many of the included reviews were small in size and authors generally relied on small numbers of studies to underpin their conclusions. The meta-review was restricted to English-language publications. Short timescales prevented any investigation of the overlap of primary studies, and growth in the evidence base since the original meta-review meant that post-protocol decisions were necessary.ConclusionsThere is no ‘one size fits all’ intervention to support carers. Potential exists for effective support in specific groups of carers. This includes shared learning, cognitive reframing, meditation and computer-delivered psychosocial support for carers of people with dementia, and psychosocial interventions, art therapy and counselling for carers of people with cancer. Counselling may also help carers of people with stroke. The effectiveness of respite care remains a paradox, given the apparent conflict between the empirical evidence and the views of carers.Future workMore good-quality, theory-based, primary research is warranted. Evidence is needed on the differential impact of interventions for various types of carers (including young carers and carers from minority groups), and on the effectiveness of constituent parts in multicomponent programmes. Further research triangulating qualitative and quantitative evidence on respite care is urgently required. The overlap of primary studies was not formally investigated in our review, and this warrants future evaluation.Study registrationThis study is registered as PROSPERO CRD42016033367.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Anxietymentioning

confidence: 99%

Section: Quality Of the Primary Studiesmentioning

confidence: 99%

Section: Mental Healthmentioning

confidence: 99%

Section: Overview Of the High-quality Reviewsmentioning

confidence: 99%

Section: Approach To Synthesismentioning

confidence: 99%

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Updated meta-review of evidence on support for carers

Thomas

Dalton

Harden

et al. 2017

Health Serv Deliv Res

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Digital interventions to reduce social isolation and loneliness in older adults: An evidence and gap map

Welch,

Ghogomu,

Barbeau

et al. 2023

Campbell Systematic Reviews

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BackgroundSocial isolation and loneliness are more common in older adults and are associated with a serious impact on their well‐being, mental health, physical health, and longevity. They are a public health concern highlighted by the COVID‐19 pandemic restrictions, hence the need for digital technology tools to enable remotely delivered interventions to alleviate the impact of social isolation and loneliness during the COVID‐19 restrictions.ObjectivesTo map available evidence on the effects of digital interventions to mitigate social isolation and/or loneliness in older adults in all settings except hospital settings.Search MethodsWe searched the following databases from inception to May 16, 2021, with no language restrictions. Ovid MEDLINE, Embase, APA PsycInfo via Ovid, CINAHL via EBSCO, Web of Science via Clarivate, ProQuest (all databases), International Bibliography of the Social Sciences (IBSS) via ProQuest, EBSCO (all databases except CINAHL), Global Index Medicus, and Epistemonikos.Selection CriteriaTitles and abstracts and full text of potentially eligible articles were independently screened in duplicate following the eligibility criteria.Data Collection and AnalysisWe developed and pilot tested a data extraction code set in Eppi‐Reviewer and data were individually extracted and coded based on an intervention‐outcome framework which was also used to define the dimensions of the evidence and gap map.Main ResultsWe included 200 articles (103 primary studies and 97 systematic reviews) that assessed the effects of digital interventions to reduce social isolation and/or loneliness in older adults. Most of the systematic reviews (72%) were classified as critically low quality, only 2% as high quality and 25% were published since the COVID‐19 pandemic. The evidence is unevenly distributed with clusters predominantly in high‐income countries and none in low‐income countries. The most common interventions identified are digital interventions to enhance social interactions with family and friends and the community via videoconferencing and telephone calls. Digital interventions to enhance social support, particularly socially assistive robots, and virtual pets were also common. Most interventions focused on reducing loneliness and depression and improving quality of life of older adults. Major gaps were identified in community level outcomes and process indicators. No included studies or reviews assessed affordability or digital divide although the value of accessibility and barriers caused by digital divide were discussed in three primary studies and three reviews. Adverse effects were reported in only two studies and six reviews. No study or review included participants from the LGBTQIA2S+ community and only one study restricted participants to 80 years and older. Very few described how at‐risk populations were recruited or conducted any equity analysis to assess differences in effects for populations experiencing inequities across PROGRESS‐Plus categories.Authors' ConclusionsThe restrictions placed on people during the pandemic have shone a spotlight onto social isolation and loneliness, particularly for older adults. This evidence and gap map shows available evidence on the effectiveness of digital interventions for reducing social isolation or loneliness in older adults. Although the evidence is relatively large and recent, it is unevenly distributed and there is need for more high‐quality research. This map can guide researchers and funders to consider areas of major gaps as priorities for further research.

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Online information and support for carers of people with young‐onset dementia: A multi‐site randomised controlled pilot study

Metcalfe

Jones

Mayer

et al. 2019

Int J Geriat Psychiatry

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Objectives The European RHAPSODY project sought to develop and test an online information and support programme for caregivers of individuals diagnosed with young onset dementia. The objectives were to assess user acceptability and satisfaction with the programme and to test outcome measures for a larger effectiveness study. Design A pilot randomised controlled trial in England, France, and Germany was conducted with 61 caregivers for adults with young onset Alzheimer's disease or frontotemporal degeneration. Evaluations at baseline, week 6, and week 12 assessed user acceptability and satisfaction. Use of the programme was measured from online back‐end data. Qualitative feedback on user experiences was collected via semi‐structured interviews. Measures of caregiver well‐being (self‐efficacy, stress, burden, frequency of patient symptoms, and caregiver reactions) were explored for use in a subsequent trial. Results Participants logged in online on average once a week over a 6‐week period, consulting approximately 31% of programme content. Seventy percent of participants described the programme as useful and easy to use. Eighty‐five percent expressed intent to use the resource in the future. Reductions in reported levels of stress and caregivers' negative reactions to memory symptoms were observed following use of the programme. Conclusions Results indicated that the RHAPSODY programme was acceptable and useful to caregivers. The programme may be complementary to existing services in responding to the specific needs of families affected by young onset dementia. Distribution of the programme is underway in England, France, Germany, and Portugal.

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Technology-Driven Interventions for Caregivers of Persons With Dementia

Cited by 160 publications

References 27 publications

Updated meta-review of evidence on support for carers

Updated meta-review of evidence on support for carers

Digital interventions to reduce social isolation and loneliness in older adults: An evidence and gap map

Online information and support for carers of people with young‐onset dementia: A multi‐site randomised controlled pilot study

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