Does Telehealth Delivery of a Dyadic Dementia Care Program Provide a Noninferior Alternative to Face-To-Face Delivery of the Same Program? A Randomized, Controlled Trial
Does Telehealth Delivery of a Dyadic Dementia Care Program Provide a Noninferior Alternative to Face-To-Face Delivery of the Same Program? A Randomized, Controlled Trial
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DOI：
10.1016/j.jagp.2020.02.009
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发表时间：
2020-06-01
影响因子：
7.2
通讯作者：
Crotty, Maria
中科院分区：
文献类型：
--
作者：
Laver, Kate;Liu, Enwu;Crotty, Maria
目的：本研究的目的是确定是否交付的二元干预使用远程医疗是不劣于交付相同的程序使用传统的面对面交付通过家访。设计：我们进行了一项非劣效性随机对照试验。参会人员：参与者被诊断患有痴呆症，生活在社区，并且有一个非正式的照顾者，他报告说在管理日常生活活动或行为症状方面存在困难。干预：参与者被随机分配接受相同干预计划的远程医疗或家庭访视。测量值：主要结果是照顾掌握指数，次要结果包括照顾者对变化的看法，日常生活功能的活动，以及痴呆症患者行为症状的类型和频率。进行干预的治疗师记录了进行干预所花费的时间以及旅行时间。结果：招募并随机化了63对二联体。两组均报告了主要结局的改善，但这些改善无统计学意义。在4个月时，两组的主要结局（平均差异0.09（95%置信区间-1.26至1.45）或次要结局）无显著差异。两组都报告了照顾者对变化的看法有了显着改善。两组之间传递计划内容所花费的时间相似，但是通过远程医疗提供干预显著减少了旅行时间（平均255.9分钟对平均77.2分钟，p
Objective: This study aimed to determine whether delivery of a dyadic intervention using telehealth was noninferior to delivery of the same program using traditional face-to-face delivery through home visits. Design: We conducted a noninferiority randomized controlled trial. Participants: Participants had a diagnosis of dementia, were living in the community, and had an informal caregiver who reported difficulties in managing activities of daily living or behavioral symptoms. Intervention: Participants were randomized to receive either telehealth or home visit delivery of the same intervention program. Measurements: The primary outcome was the Caregiving Mastery Index, secondary outcomes included caregiver's perceptions of change, activities of daily living function, and type and frequency of behavioral symptoms of persons living with dementia. Therapists delivering the intervention recorded the time spent delivering the intervention as well as travel time. Results: Sixty-three dyads were recruited and randomized. Both groups reported improvements for the primary outcome, however, these were not statistically significant. There were no significant differences between groups for the primary outcome (mean difference 0.09 (95% confidence interval -1.26 to 1.45) or the secondary outcomes at 4 months. Both groups reported significant improvements in caregiver's perceptions of change. The amount of time spent delivering the content of the program was similar between groups, however offering the intervention via telehealth significantly reduced travel time (mean 255.9 minutes versus mean 77.2 minutes, p