Effectiveness, feasibility, and acceptance of a general practice-based supportive intervention for dementia...

This study evaluated the effectiveness, feasibility, and acceptance of a caregiver-need-driven intervention to reduce caregiver burden among informal caregivers of people with dementia, delivered by non-physician medical staff of general practices in Switzerland.

In this prospective, single-group, pre-post superiority trial, non-physician medical practice staff were trained to deliver a supportive intervention for informal dementia caregivers involving three home visits and optional home-based and/or telephone counseling. Comparator was the "usual care" arm of the randomized DE-REACH trial in a similar setting. Primary outcome was increase in caregiver burden at six months, measured by the Zarit Burden Interview (ZBI) and analyzed by one-sample superiority t-test. Secondary outcomes included changes in quality of life. Hierarchical regression served to identify associations between outcomes and participant characteristics.

Among 32 non-physician medical practice staff (96.9% female, mean 14.6 years of professional experience) and 55 informal caregivers (69.1% female, mean age 70.0 years), the intervention proved superior to usual care by significantly attenuating the increase in caregiver burden (mean ZBI score increase 2.65 [95% confidence interval: -∞ to 4.10] vs. 7, p = 0.017). There was no significant change in quality of life during the intervention, which was well feasible and accepted by caregivers and health professionals.

This study demonstrated that a scalable, caregiver-need-driven intervention by trained non-physician medical staff in general practices mitigated the rise in caregiver burden over six months. The intervention holds potential to enhance the efficacy of general practice teams in supporting the frequently overlooked dementia patient-caregiver dyad, thereby improving their well-being and the quality of care provided.

ISRCTN55348828 , registered 12/10/2021.