Effectiveness of family meetings for family caregivers on delaying time to nursing home placement of dementia patients: a randomized trial.

<h4>Background</h4>Interventions relieving the burden of caregiving may postpone or prevent patient institutionalization. The objective of this study was to determine whether a family meetings intervention was superior to usual care in postponing nursing home placement of patients with d...

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Autores principales:	Karlijn J Joling, Harm W J van Marwijk, Henriëtte E van der Horst, Philip Scheltens, Peter M van de Ven, Bregje A Appels, Hein P J van Hout
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/252533f22199445b9f9f9789981ec2b4
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spelling	oai:doaj.org-article:252533f22199445b9f9f9789981ec2b42021-11-18T07:09:57ZEffectiveness of family meetings for family caregivers on delaying time to nursing home placement of dementia patients: a randomized trial.1932-620310.1371/journal.pone.0042145https://doaj.org/article/252533f22199445b9f9f9789981ec2b42012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22876304/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Interventions relieving the burden of caregiving may postpone or prevent patient institutionalization. The objective of this study was to determine whether a family meetings intervention was superior to usual care in postponing nursing home placement of patients with dementia.<h4>Methods</h4>A randomized multicenter trial was conducted among 192 patients with a clinical diagnosis of dementia living at home at enrolment and their primary family caregiver. Dyads of caregivers and patients were randomized to the family meetings intervention (n = 96) or usual care (n = 96) condition. The intervention consisted of two individual sessions with the primary caregiver and four family counseling sessions that included family members and friends. The primary outcome measure was the time until institutionalization of the patient. Intention-to-treat as well as per protocol analyses were performed. Survival analyses were carried out to evaluate the effectiveness of the intervention.<h4>Results</h4>During 18 months follow-up 23 of 96 relatives with dementia of caregivers in the intervention group and 18 of 96 relatives with dementia of caregivers in the usual care group were institutionalized. No significant difference between the intervention and the usual care group was found in time until institutionalization (adjusted hazard ratio (HR) 1.46, 95% confidence interval (CI) 0.78 to 2.74). The per-protocol analysis revealed no significant effect either (adjusted HR 0.57, 95% CI 0.21 to 1.57), although the number of placements among the adherers was relatively low (9.4%). A subgroup effect was found for patients' age, with a significantly higher risk of institutionalization for 'younger' patients in the intervention group compared with the usual care group (adjusted HR = 4.94, 95% CI 1.10 to 22.13).<h4>Conclusion</h4>This family meetings intervention for primary caregivers of patients with dementia did not postpone patient institutionalization more than usual care.<h4>Trial registration</h4>CONTROLLED-TRIALS.COM ISRCTN90163486.Karlijn J JolingHarm W J van MarwijkHenriëtte E van der HorstPhilip ScheltensPeter M van de VenBregje A AppelsHein P J van HoutPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 8, p e42145 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Karlijn J Joling Harm W J van Marwijk Henriëtte E van der Horst Philip Scheltens Peter M van de Ven Bregje A Appels Hein P J van Hout Effectiveness of family meetings for family caregivers on delaying time to nursing home placement of dementia patients: a randomized trial.
description	<h4>Background</h4>Interventions relieving the burden of caregiving may postpone or prevent patient institutionalization. The objective of this study was to determine whether a family meetings intervention was superior to usual care in postponing nursing home placement of patients with dementia.<h4>Methods</h4>A randomized multicenter trial was conducted among 192 patients with a clinical diagnosis of dementia living at home at enrolment and their primary family caregiver. Dyads of caregivers and patients were randomized to the family meetings intervention (n = 96) or usual care (n = 96) condition. The intervention consisted of two individual sessions with the primary caregiver and four family counseling sessions that included family members and friends. The primary outcome measure was the time until institutionalization of the patient. Intention-to-treat as well as per protocol analyses were performed. Survival analyses were carried out to evaluate the effectiveness of the intervention.<h4>Results</h4>During 18 months follow-up 23 of 96 relatives with dementia of caregivers in the intervention group and 18 of 96 relatives with dementia of caregivers in the usual care group were institutionalized. No significant difference between the intervention and the usual care group was found in time until institutionalization (adjusted hazard ratio (HR) 1.46, 95% confidence interval (CI) 0.78 to 2.74). The per-protocol analysis revealed no significant effect either (adjusted HR 0.57, 95% CI 0.21 to 1.57), although the number of placements among the adherers was relatively low (9.4%). A subgroup effect was found for patients' age, with a significantly higher risk of institutionalization for 'younger' patients in the intervention group compared with the usual care group (adjusted HR = 4.94, 95% CI 1.10 to 22.13).<h4>Conclusion</h4>This family meetings intervention for primary caregivers of patients with dementia did not postpone patient institutionalization more than usual care.<h4>Trial registration</h4>CONTROLLED-TRIALS.COM ISRCTN90163486.
format	article
author	Karlijn J Joling Harm W J van Marwijk Henriëtte E van der Horst Philip Scheltens Peter M van de Ven Bregje A Appels Hein P J van Hout
author_facet	Karlijn J Joling Harm W J van Marwijk Henriëtte E van der Horst Philip Scheltens Peter M van de Ven Bregje A Appels Hein P J van Hout
author_sort	Karlijn J Joling
title	Effectiveness of family meetings for family caregivers on delaying time to nursing home placement of dementia patients: a randomized trial.
title_short	Effectiveness of family meetings for family caregivers on delaying time to nursing home placement of dementia patients: a randomized trial.
title_full	Effectiveness of family meetings for family caregivers on delaying time to nursing home placement of dementia patients: a randomized trial.
title_fullStr	Effectiveness of family meetings for family caregivers on delaying time to nursing home placement of dementia patients: a randomized trial.
title_full_unstemmed	Effectiveness of family meetings for family caregivers on delaying time to nursing home placement of dementia patients: a randomized trial.
title_sort	effectiveness of family meetings for family caregivers on delaying time to nursing home placement of dementia patients: a randomized trial.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/252533f22199445b9f9f9789981ec2b4
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Effectiveness of family meetings for family caregivers on delaying time to nursing home placement of dementia patients: a randomized trial.

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