Alzheimer's Disease Clinical Trial
Official title:
Caregiver Psychoeducation and Support: Improving Outcomes in AD/ADRD
This study is piloting an internet-based intervention to provide support for caregivers of VA patients with Alzheimer's disease or related memory difficulties (ADRD). Veterans with a clinical diagnosis of ADRD and their caregiver/relatives will be randomized to receive one of two interventions: (1) customary care (cc) and access to an intensive, interactive online education and support website intervention for 6 months, or (2) cc and monthly brief telephone calls with project staff for six month. It is hypothesized that participation in the intensive intervention will result in a reductions in patient problematic behavior and caregiver responses to it, reduced caregiver burden and depression, and improved medication adherence at the end of treatment, and more patients remaining at home through the 12 months post-randomization period..
Alzheimer's disease (AD) is a progressive brain disease resulting in cognitive and
functional decline. While some pharmacological agents and behavioral programs are now
available to slow the rate of decline, there is no cure. Caregivers, who typically are the
female spouses or daughters of afflicted individuals, must confront both the deterioration
of a loved one, and that person's need for increasingly demanding care. Caregivers tend to
experience high levels of depression, anxiety, and burden. Data suggest that providing
education, social support, and ongoing professional consultation to families involved in the
care of a relative with AD results in improvement in caregiver psychological status, and
sometimes even slows the functional decline of the patient.
Recent technological advancements in video conferencing, online communication, and streaming
audio/video presentations, which are increasingly easy to use and gaining widespread
acceptance among mental health professionals as well as the public, have given rise to a
great deal of interest in telemedicine and telepsychiatry. This study tested an
Internet-based family intervention for AD that relatives can access from their homes with
ease, and at no cost. In addition to improving patient outcomes through instruction of
effective behavioral management, we proposed that participation in an Internet program would
also reduce caregiver depression and burden. Fifty-three veterans with a clinical diagnosis
of AD and their caregiver/relatives were randomized to receive one of two interventions: (1)
customary care (cc) and access to an intensive, interactive online education and support
website intervention for 6 months, or (2) cc and monthly brief telephone calls with project
staff for 6 months. We hypothesized that, at the end of the active intervention,
participation in the intensive intervention would result reduced patient problematic
behavior, caregiver burden, depression, and negative responses to problematic patient
behaviors, as well as improved patient medication compliance. At 12 month follow-up, we
hypothesized access to the online program would result in more patients remaining at home.
The overriding longterm project objective was to develop an effective online education and
support program for caregivers of patients with AD that can be manualized, replicated, and
disseminated to other clinical and research centers, within both the VA health care system
and the community, to enhance the efficiency and effectiveness of psychosocial treatment in
AD.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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