Eerder Erbij: The Path Towards Offering Timely Support for People With Dementia and Their Caregivers
NCT ID: NCT06455163
Last Updated: 2024-08-15
Study Results
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Basic Information
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RECRUITING
NA
102 participants
INTERVENTIONAL
2021-06-01
2026-05-31
Brief Summary
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It has been estimated that at least 50% of the home living persons with dementia in the Netherlands receive little or no formal care and support (Zorgstandaard Dementie, 2013). Reasons why persons with dementia and their informal caregivers receive no formal care vary, include absence of diagnosis, denial of illness, embarrassment or the complexity of the care and referral system. A common concern among health care professionals is that by the time the person with dementia or informal caregiver do seek or receive formal care it may be too late. The difficulties at home may already be so severe that there is little that community-based care can do and admission to residential care may follow soon after. Appropriate support at an earlier stage may prevent more serious difficulties and postpone admission to residential care. Therefore, health care professionals are looking for strategies to reach persons with dementia and caregivers in an earlier stage of dementia and encourage them to accept some form of help or support. The rationale of this study is to investigate how persons living with dementia and their close others can be encouraged to accept support and whether support at an early stage is effective in preventing severe deterioration in wellbeing, behavioural difficulties and high care costs later on.
OBJECTIVES
* Estimate the effect of EE on caregiver self-efficacy compared to usual care
* Estimate the effect of EE on the total care costs of caregiver and person with dementia compared to usual care
* Estimate the cost-effectiveness and cost-utility of EE compared to usual care
* Perform a process evaluation to monitor delivery of EE and experiences of persons with dementia, caregivers and care professionals
* Explore treatment responsiveness of EE in terms of self-efficacy and quality of life
STUDY DESIGN
Pragmatic, cluster randomised controlled trial.
STUDY POPULATION
Informal caregivers and people with early-stage dementia, who are community dwelling and receive little or no dementia-related formal ADL care.
INTERVENTION
The intervention (Eerder Erbij, EE) is a person-centred, manual-based intervention consisting of education, information and a support group.
MAIN STUDY PARAMETERS/ENDPOINTS
Primary: self-efficacy. Cost-utility: EQ5D, RUD. Secondary: quality-of-life, caregiver burden.
DATA COLLECTION
Measurements consist of questionnaires (total duration is approximately 1 hour; administered at home; take place at baseline, 3, 6, and 12 months).
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
SUPPORTIVE_CARE
NONE
Study Groups
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Eerder Erbij (intervention group)
Informal caregivers and people with dementia assigned to the intervention group will receive the 6-week intervention "Eerder Erbij".
Eerder Erbij
The intervention (Eerder Erbij, EE) is a person-centred, manual-based intervention consisting of education, information and a support group for persons in the early stage of dementia and their main informal caregiver (e.g. spouse, relative), who receive little or no formal care. The intervention will discuss the effects of dementia, and how to cope and adjust to those effects. It will take place in small group sessions led by a health care professional (e.g. casemanager) and is intended for both the person with dementia and the caregiver. The intervention will be personalised to meet needs, interests and strengths of the dyad by discussing the sessions content at the start of the intervention.
Usual/standard care (control group)
Participants in the comparison condition will continue to receive usual care. Care for people with dementia in the Netherlands varies across municipalities, but the majority lives at home and especially earlier stages of the disease, most people living with dementia and their informal caregivers use no or very little formal care, apart from occasional visitors to GP or by case manager.
The control group will be shared with another collaborating study from 'Maastricht University', which has the same goals, applies the same inclusion criteria, applies the same study procedures, and obtains the same outcomes. This implies that the data of the participants recruited for the control group for this study will be shared with the collaborating study.
No interventions assigned to this group
Interventions
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Eerder Erbij
The intervention (Eerder Erbij, EE) is a person-centred, manual-based intervention consisting of education, information and a support group for persons in the early stage of dementia and their main informal caregiver (e.g. spouse, relative), who receive little or no formal care. The intervention will discuss the effects of dementia, and how to cope and adjust to those effects. It will take place in small group sessions led by a health care professional (e.g. casemanager) and is intended for both the person with dementia and the caregiver. The intervention will be personalised to meet needs, interests and strengths of the dyad by discussing the sessions content at the start of the intervention.
Eligibility Criteria
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Inclusion Criteria
* The person with dementia must be living at home cared for by the caregiver.
* The person with dementia should have a diagnosis of dementia or experience severe cognitive impairments suggesting dementia. Type of dementia is not an inclusion criterion.
* The person with dementia is not yet receiving formal care related to personal activities of daily living on account of his or her dementia more than once a week (defined by receiving assistance from a paid worker by e.g., health or social care professional as help with dressing/undressing; washing/bathing/showering; toileting; feeding/drinking; or taking medication).
Exclusion Criteria
* Dementia is caused by human immunodeficiency virus (HIV), acquired brain impairment, Down syndrome, chorea associated with Huntington's disease, or alcohol abuse.
* Inability to give informed consent will also be an exclusion criterion.
* Informal caregiver is younger than 18 years old.
18 Years
ALL
Yes
Sponsors
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ZonMw: The Netherlands Organisation for Health Research and Development
OTHER
Maastricht University
OTHER
VU University of Amsterdam
OTHER
Responsible Party
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Sanne Balvert
Principal Investigator
Locations
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Klinische Neuropsychologie
Amsterdam, North Holland, Netherlands
Countries
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Central Contacts
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References
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Osstyn SL, Handels R, Boots LMM, Balvert SCE, Evers SMAA, de Vugt ME. The effectiveness and health-economic evaluation of "Partner in Balance," a blended self-management program for early-stage dementia caregivers: study protocol for a cluster-randomized controlled trial. Trials. 2023 Jun 22;24(1):427. doi: 10.1186/s13063-023-07423-9.
Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res. 2002 Feb;52(2):69-77. doi: 10.1016/s0022-3999(01)00296-3.
Fortinsky RH, Kercher K, Burant CJ. Measurement and correlates of family caregiver self-efficacy for managing dementia. Aging Ment Health. 2002 May;6(2):153-60. doi: 10.1080/13607860220126763.
Logsdon RG, Gibbons LE, McCurry SM, Teri L. Assessing quality of life in older adults with cognitive impairment. Psychosom Med. 2002 May-Jun;64(3):510-9. doi: 10.1097/00006842-200205000-00016.
Makai P, Looman W, Adang E, Melis R, Stolk E, Fabbricotti I. Cost-effectiveness of integrated care in frail elderly using the ICECAP-O and EQ-5D: does choice of instrument matter? Eur J Health Econ. 2015 May;16(4):437-50. doi: 10.1007/s10198-014-0583-7. Epub 2014 Apr 24.
Wimo A, Gustavsson A, Jonsson L, Winblad B, Hsu MA, Gannon B. Application of Resource Utilization in Dementia (RUD) instrument in a global setting. Alzheimers Dement. 2013 Jul;9(4):429-435.e17. doi: 10.1016/j.jalz.2012.06.008. Epub 2012 Nov 9.
Pot AM, van Dyck R, Deeg DJ. [Perceived stress caused by informal caregiving. Construction of a scale]. Tijdschr Gerontol Geriatr. 1995 Oct;26(5):214-9. Dutch.
Other Identifiers
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852002106
Identifier Type: -
Identifier Source: org_study_id
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