Online Caregiver Psychoeducation and Support for Alzheimer's
Condition: Alzheimer's Disease
MeSH terms: Alzheimer Disease
Study type: Interventional
Phase: Phase 2/Phase 3

Summary: 
      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..
    

Detailed description: 
      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.
    

Intervention name(s): caregiver website support; caregiver brief supportive phone calls
Intervention type(s): Behavioral; Behavioral
Intervention description(s): caregiver access to website support for 6 months embedded in one year of customary care; caregiver brief supportive telephone calls for 6 months embedded in one year of customary care
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: technology development and assessment; internet; randomized control trial