TY - JOUR

T1 - Peer support and reminiscence therapy for people with dementia and their family carers

T2 - A factorial pragmatic randomised trial

AU - Charlesworth, G.

AU - Burnell, K.

AU - Crellin, N.

AU - Hoare, Zoe

AU - Hoe, J.

AU - Knapp, M.

AU - Russel, I.T.

AU - Wenborn, J.

AU - Woods, Robert

AU - Orrell, M.

N1 - The SHIELD research programme was sponsored by the North East London NHS Foundation Trust and funded by the National Institute for Health Research (NIHR) programme grant number RP-PG-0606-1083.

PY - 2017/11

Y1 - 2017/11

N2 - Objective The objective of this study was to evaluate peer support and reminiscence therapy, separately and together, in comparison with usual care for people with dementia and their family carers.Design Factorial pragmatic randomised trial, analysed by treatment allocated, was used for this study.Setting The trial ran in Community settings in England.Participants People with dementia and their family carers were the participants.Interventions Treatment as usual (TAU) plus one of the following: one-to-one peer support to family carers from experienced carers (Carer Supporter Programme; CSP), group reminiscence therapy (Remembering Yesterday, Caring Today; RYCT) for people with dementia and carers, both or neither.Main outcome measures Primary outcomes included health-related quality of life (SF-12) for carers and quality of life (QoL-AD) for people with dementia; secondary outcomes included quality of relationship for carers and people with dementia; both were collected by blinded assessors at baseline, 5 and 12 months (primary end point).Results Of 291 pairs recruited, we randomised 145 (50%) to CSP (71% uptake) and 194 (67%) to RYCT (61% uptake). CSP and RYCT, separately or together, were not effective in improving primary outcomes or most secondary outcomes. For CSP versus ‘no CSP’, adjusted difference in means was 0.52 points on the SF-12 (95% CI −1.28 to 2.32) and −0.08 points on the QoL-AD (95% CI −1.70 to 1.56). For RYCT versus ‘no RYCT’, the difference was 0.10 points on the SF-12 (95% CI −1.72 to 1.93) and 0.51 points on the QoL-AD (95% CI −1.17 to 2.08). However, carers reported better relationships with the people with dementia (difference 1.11, 95% CI 0.00 to 2.21, p=0.05). Comparison of combined intervention with TAU, and of intervention received, suggested differential impacts for carers and persons with dementia.Conclusions There is no evidence from the trial that either peer support or reminiscence is effective in improving the quality of life.

AB - Objective The objective of this study was to evaluate peer support and reminiscence therapy, separately and together, in comparison with usual care for people with dementia and their family carers.Design Factorial pragmatic randomised trial, analysed by treatment allocated, was used for this study.Setting The trial ran in Community settings in England.Participants People with dementia and their family carers were the participants.Interventions Treatment as usual (TAU) plus one of the following: one-to-one peer support to family carers from experienced carers (Carer Supporter Programme; CSP), group reminiscence therapy (Remembering Yesterday, Caring Today; RYCT) for people with dementia and carers, both or neither.Main outcome measures Primary outcomes included health-related quality of life (SF-12) for carers and quality of life (QoL-AD) for people with dementia; secondary outcomes included quality of relationship for carers and people with dementia; both were collected by blinded assessors at baseline, 5 and 12 months (primary end point).Results Of 291 pairs recruited, we randomised 145 (50%) to CSP (71% uptake) and 194 (67%) to RYCT (61% uptake). CSP and RYCT, separately or together, were not effective in improving primary outcomes or most secondary outcomes. For CSP versus ‘no CSP’, adjusted difference in means was 0.52 points on the SF-12 (95% CI −1.28 to 2.32) and −0.08 points on the QoL-AD (95% CI −1.70 to 1.56). For RYCT versus ‘no RYCT’, the difference was 0.10 points on the SF-12 (95% CI −1.72 to 1.93) and 0.51 points on the QoL-AD (95% CI −1.17 to 2.08). However, carers reported better relationships with the people with dementia (difference 1.11, 95% CI 0.00 to 2.21, p=0.05). Comparison of combined intervention with TAU, and of intervention received, suggested differential impacts for carers and persons with dementia.Conclusions There is no evidence from the trial that either peer support or reminiscence is effective in improving the quality of life.

U2 - 10.1136/jnnp-2016-313736

DO - 10.1136/jnnp-2016-313736

M3 - Article

VL - 87

SP - 1218

EP - 1228

JO - Journal of Neurology, Neurosurgery, and Psychiatry

JF - Journal of Neurology, Neurosurgery, and Psychiatry

SN - 0022-3050

IS - 11

ER -