Dataset Information

A multicentre RCT on community occupational therapy in Alzheimer's disease: 10 sessions are not better than one consultation.

ABSTRACT:

Objective

To compare the benefits and harms of a Dutch 10-session Community Occupational Therapy programme for patients with Alzheimer's disease with the impact of a one session consultation at home in German routine healthcare.

Design

A seven-centre, parallel group, active controlled randomised controlled trial. Patients and carers were not masked. Assessors were fully blind for treatment allocation for one of two primary-outcome measurements.

Setting

Patients' homes.

Participants

Patients with mild to moderate Alzheimer's disease (Mini-Mental State Examination 14-24), living in the community with primary carer available and without severe depression or behavioural symptoms, were eligible.

Interventions

Experimental 10 home visits within 5 weeks by an occupational therapist, educating patients in the performance of simplified daily activities and in the use of aids to compensate for cognitive decline; and educating carers in coping with behaviour of the patient and in giving supervision to the patient. Control one home visit including individual counselling of patient and carer and explanation of a leaflet on coping with dementia in daily life.

Outcome measures

The primary outcome was the patient's daily functioning measured with the Interview of Deterioration in Daily activities in Dementia and the Perceive, Recall, Plan and Perform System of Task Analysis. Assessments were at baseline, 6, 16 and 26 weeks, with a postal assessment at 52 weeks.

Results

141 patients were 1:1 randomised to the experimental (N=71) and control group (N=70). Data for 54 and 50 participants were analysed. Patients' daily functioning did not differ significantly between the experimental and control group at week 6, 16, 26 or 52 and remained stable over 26 weeks in both groups. No adverse events were associated with the interventions.

Conclusions

In German healthcare, a Dutch 10-session community occupational therapy was not better than a one-session consultation for the daily functioning of patients with Alzheimer's disease. Further research on the transfer of complex psychosocial is needed. International Clinical Trials Registry Platform DRKS00000053; Funded by the German Federal Ministry of Health.

SUBMITTER: Voigt-Radloff S

PROVIDER: S-EPMC3191435 | biostudies-literature | 2011 Aug

REPOSITORIES: biostudies-literature

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Publications

A multicentre RCT on community occupational therapy in Alzheimer's disease: 10 sessions are not better than one consultation.

Voigt-Radloff Sebastian S Graff Maud M Leonhart Rainer R Schornstein Katrin K Jessen Frank F Bohlken Jens J Metz Brigitte B Fellgiebel Andreas A Dodel Richard R Eschweiler Gerhard G Vernooij-Dassen Myrra M Olde Rikkert Marcel M Hüll Michael M

BMJ open 20110809 1

<h4>Objective</h4>To compare the benefits and harms of a Dutch 10-session Community Occupational Therapy programme for patients with Alzheimer's disease with the impact of a one session consultation at home in German routine healthcare.<h4>Design</h4>A seven-centre, parallel group, active controlled randomised controlled trial. Patients and carers were not masked. Assessors were fully blind for treatment allocation for one of two primary-outcome measurements.<h4>Setting</h4>Patients' homes.<h4>P ...[more]

PMID: 22021760

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Project description:IntroductionSocioeconomically vulnerable individuals often face poor access to nutritious food and bear a disproportionate burden of diet-related chronic illness. This study tested whether a subsidized community-supported agriculture intervention could improve diet quality.Study designAn RCT was conducted from May 2017 to December 2018 (data analyzed in 2019).Setting/participantsAdults with a BMI >25 kg/m2 seen at a community health center in central Massachusetts, or who lived in the surrounding county, were eligible.InterventionIndividuals were randomized to receive either subsidized community-supported agriculture membership (which provided a weekly farm produce pickup from June to November) or healthy eating information (control group). For equity, the control group received financial incentives similar to the intervention group.Main outcome measuresThe primary outcome was the Healthy Eating Index 2010 total score (range, 0-100; higher indicates better diet quality; minimum clinically meaningful difference, 3). Healthy Eating Index was assessed using 3 24-hour recalls per participant collected each growing season. Intention-to-treat analyses compared Healthy Eating Index scores between the intervention and control group, accounting for repeated measures with generalized estimating equations.ResultsThere were 128 participants enrolled and 122 participants for analysis. The participants' mean age was 50.3 (SD=13.6) years; 82% were women; and 88% were white, non-Hispanic, with a similar distribution of baseline characteristics comparing the intervention and control groups. Baseline Healthy Eating Index total score was 53.9 (SD=15.3) in the control group and 55.1 (SD=15.2) in the intervention group (p=0.68). The intervention increased the mean Healthy Eating Index total score relative to the control group (4.3 points higher, 95% CI=0.5, 8.1, p=0.03). Food insecurity was lower in the intervention group (RR=0.68, 95% CI=0.48, 0.96).ConclusionsA community-supported agriculture intervention resulted in clinically meaningful improvements in diet quality. Subsidized community-supported agriculture may be an important intervention for vulnerable individuals.Trial registrationThis study is registered at www.clinicaltrials.gov NCT03231592.Supplement informationThis article is part of a supplement entitled Identifying and Intervening on Social Needs in Clinical Settings: Evidence and Evidence Gaps, which is sponsored by the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services, Kaiser Permanente, and the Robert Wood Johnson Foundation.

Dataset Information

A multicentre RCT on community occupational therapy in Alzheimer's disease: 10 sessions are not better than one consultation.

Objective

Design

Setting

Participants

Interventions

Outcome measures

Results

Conclusions

Publications

A multicentre RCT on community occupational therapy in Alzheimer's disease: 10 sessions are not better than one consultation.

Similar Datasets

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