Clinical Interventions in Aging (Jul 2021)
Effects of Caregiver Dementia Training in Caregiver–Patient Dyads on Psychotropic Drug Prescription: A Randomized Controlled Study
Abstract
Elizabeth G Birkenhäger-Gillesse,1,2 Sarah IM Janus,1 Wilco P Achterberg,3 Sytse U Zuidema1 1Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; 2Laurens Care Centers, Division Long Stay, Rotterdam, the Netherlands; 3Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the NetherlandsCorrespondence: Elizabeth G Birkenhäger-GillesseLaurens Care Centers, Division Long Stay, Pres. Rooseveltweg 22, Rotterdam, 3068 TR, the NetherlandsTel +31619699113Email [email protected]: Does participating in a multicomponent intervention targeting caregivers change the prescription rates of psychotropic drugs of caregivers or the person with dementia (PWD) they live with and care for.Patients and Methods: Participants were 142 dyads of community-dwelling cohabiting caregivers and PWD randomized to intervention or control (care as usual). Participating caregivers received the intervention in a holiday accommodation over five days in groups of two to six dyads. During this time, caregivers attended 14 psychoeducational group sessions on relevant emotional, relational, practical, financial, and social changes related to living with PWD. These sessions were delivered by a psychologist, a physiotherapist, an occupational therapist, an elderly care physician, a dietician and a social worker and included combating social isolation, planning for the future, re-rolling, medical aspects of dementia, fitness, therapeutic use of facilities, nutrition and using community services. The design was a randomized controlled trial. Outcomes were compared 3 months after baseline. Drug use for both caregivers and PWD were reported as all psychotropic drug use and specified as antipsychotic, antidepressant, and anxiolytic and hypnotic drug use based on Anatomical Therapeutic Chemical (ATC) classifications.Results: Compared to the control group, no significant difference was observed in psychotropic drug use by 3 months after baseline among caregivers (p 0.22 MD − 0.08 95% CI − 0.20– 0.05) or PWD (p 0.61, MD 0.04 95% − 0.12– 0.21) in the intervention group.Conclusion: A multicomponent course for caregivers living with PWD did not affect psychotropic drug use by either person. This may be explained by the low level of baseline drug use and the lack of the prescribing physician involvement in the present study. The low baseline drug use likely reflects selection bias for caregiver participants who were more inclined to use psychosocial interventions in preference to psychotropic medication, making them more likely to participate in caregiver training.Keywords: caregiver, dementia, psychotropic drugs, psychosocial intervention, training
