Caution must therefore be exercised in interpreting results , but the case for investment in parenting and health visitor-related programmes appears most strong , especially when impacts beyond the health sector are taken into account .
In the workplace an economic return on investment in a number of comprehensive workplace health promotion programmes and stress management projects ( largely in the USA ) was reported , while group-based exercise and psychosocial interventions are of potential benefit to older people .
(Cost)-effectiveness of family meetings on indicated prevention of anxiety and depressive symptoms and disorders of primary family caregivers of patients with dementia: design of a randomized controlled trial
Background Dementia is a major public health problem with enormous costs to society and major consequences for both patients and their relatives . Family members of persons with dementia provide much of the care for older adults with dementia in the community . Caring for a demented relative is not easy and fraught with emotional strain , distress , and physical exhaustion . Family caregivers of dementia patients have an extremely high risk developing affective disorders such as major depression and anxiety disorder . Family meetings appear to be among the most powerful psychosocial interventions to reduce depression in caregivers . An American l and mark study reported substantial beneficial effects of a multifaceted intervention where family meetings had a central place on depression in family caregivers as well as on delay of institutionalization of patients . These effects were not replicated in other countries yet . We perform the first trial comparing only structured family meetings with significant others versus usual care among primary family caregivers of community dwelling demented patients and measure the effectiveness on both depression and anxiety in the primary caregiver , both on disorder and symptom levels . Methods / design In this r and omized controlled trial effectiveness as well as cost-effectiveness of family meetings is evaluated . The intervention group receives  four family meetings with family and close friends of the primary family caregiver of a community dwelling patient with a clinical diagnosis of dementia . Dyads of patients and their primary caregiver are followed up to one year after baseline assessment . The main outcome measures are the incidence of anxiety and depressive disorders assessed with the Mini-International Neuropsychiatric Interview ( MINI ) and the severity of anxiety and depressive symptoms in caregivers is measured by vali date d self report instruments : the Centre for Epidemiologic Studies Depression Scale ( CES-D ) for depression and the anxiety scales of the Hospital Anxiety and Depression scales ( HADS ) for anxiety . The economic evaluation is performed from a societal perspective . Discussion By evaluating the effectiveness of only structured family meetings organized in the Netherl and s , this study will contribute to the existing literature about the value of psychosocial interventions for dementia caregivers . Trial registration Dutch Trial Registry IS RCT
Caution must therefore be exercised in interpreting results , but the case for investment in parenting and health visitor-related programmes appears most strong , especially when impacts beyond the health sector are taken into account .
In the workplace an economic return on investment in a number of comprehensive workplace health promotion programmes and stress management projects ( largely in the USA ) was reported , while group-based exercise and psychosocial interventions are of potential benefit to older people .