Study protocol

Systematic care for caregivers of people with dementia in the ambulatory mental health service: designing a multicentre, cluster, randomized, controlled trial

Anouk Spijker^1,2 , Frans Verhey³ , Maud Graff^1,2 , Richard Grol¹ , Eddy Adang⁴ , Hub Wollersheim¹ and Myrra Vernooij-Dassen^1,2,5,6

¹Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

²Alzheimer Centre Radboud University, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

³Department of Psychiatry/Alzheimer Centre Maastricht, University Hospital of Maastricht, Maastricht, The Netherlands

⁴Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

⁵Department of primary care and nursing home medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

⁶Kalorama Foundation, Beek-Ubbergen, The Netherlands

author email corresponding author email

BMC Geriatrics 2009, 9:21doi:10.1186/1471-2318-9-21

Published:	7 June 2009

Abstract

Background

Care for people with dementia and their informal caregivers is a challenging aim in healthcare. There is an urgent need for cost-effective support programs that prevent informal caregivers of people with dementia from becoming overburdened, which might result in a delay or decrease of patient institutionalization. For this reason, we have developed the Systematic Care Program for Dementia (SCPD). The SCPD consists of an assessment of caregiver's sense of competence and suggestions on how to deal with competence deficiencies. The efficiency of the SCPD will be evaluated in our study.

Methods and design

In our ongoing, cluster, randomized, single-blind, controlled trial, the participants in six mental health services in four regions of the Netherlands have been randomized per service. Professionals of the ambulatory mental health services (psychologists and social psychiatric nurses) have been randomly allocated to either the intervention group or the control group. The study population consists of community-dwelling people with dementia and their informal caregivers (patient-caregiver dyads) coming into the health service. The dyads have been clustered to the professionals. The primary outcome measure is the patient's admission to a nursing home or home for the elderly at 12 months of follow-up. This measure is the most important variable for estimating cost differences between the intervention group and the control group. The secondary outcome measure is the quality of the patient's and caregiver's lives.

Discussion

A novelty in the SCPD is the pro-active and systematic approach. The focus on the caregiver's sense of competence is relevant to economical healthcare, since this sense of competence is an important determinant of delay of institutionalization of people with dementia. The SCPD might be able to facilitate this with a relatively small cost investment for caregivers' support, which could result in a major decrease in costs in the management of dementia. Implementation on a national level will be started if the SCPD proves to be efficient.

Trial Registration

NCT00147693