Effectiveness and cost-effectiveness of an internet intervention for family caregivers of people with dementia: design of a randomized controlled trial

ABSTRACT

Background: The number of people with dementia is rising rapidly as a consequence of the greying of the world population. There is an urgent need to develop cost effective approaches that meet the needs of people with dementia and their family caregivers. Depression, feelings of burden and caregiver stress are common and serious health problems in these family caregivers. Different kinds of interventions are developed to prevent or reduce the negative psychological consequences of caregiving. The use of internet interventions is still very limited, although they may be a cost effective way to support family caregivers in an earlier stage and diminish their psychological distress in the short and longer run.

Methods/design: A pragmatic randomized controlled trial is designed to evaluate the effectiveness and cost-effectiveness of ‘Mastery over Dementia’, an internet intervention for caregivers of people with dementia. The intervention aims at prevention and decrease of psychological distress, in particular depressive symptoms. The experimental condition consists of an internet course with 8 sessions and a booster session over a maximum period of 6 months guided by a psychologist. Caregivers in the comparison condition receive a minimal intervention. In addition to a pre and post measurement, an intermediate measurement will be conducted. In addition, there will be two follow-up measurements 3 and 6 months after post-treatment in the experimental group only. To study the effectiveness of the intervention, depressive symptoms are used as the primary outcome, whereas symptoms of anxiety, role overload and caregiver perceived stress are used as secondary outcomes. To study which caregivers profit most of the internet intervention, several variables that may modify the impact of the intervention are taken into account. Regarding the cost-effectiveness, an economic evaluation will be conducted from a societal perspective.

Discussion: This study will provide evidence about the effectiveness and cost-effectiveness of an internet intervention for caregivers. If both can be shown, this might set the stage for the development of a range of internet interventions in the field of caregiving for people with dementia. This is even more important because future generations of caregivers will be more familiar with the use of internet.

My Opinion:

This study try to design a RCT to evaluate the effectiveness and cost-effectiveness of an internet intervention for caregivers of people with dementia. In the background, this study stated that research has shown that particular types of interventions are effective.

Internet intervention could be an effective program because family caregivers may favor internet interventions instead of meeting in a group or meeting with a professional face-to-face, due to lack of time or preferences concerning privacy. Caregivers may also be unwilling to visit a mental health care institute for themselves because in their view they are not the ones who need help.

One of the main characteristics of effective interventions is a psychological rather than purely educational approach. That's from the content of the intervention given to the caregiver, stated by the author of this study design. 

One thing I see quiet good in this study is the economic analyses. This economic evaluation will involve both a costeffectiveness analysis (CEA) and a cost-utility analysis (CUA). From this analysis, it will be more clear to see if this kind of intervention will be cost effective or not.

Reference : https://www.researchgate.net/publication/280099823_Effectiveness_and_cost-effectiveness_of_an_internet_intervention_for_family_caregivers_of_people_with_dementia_design_of_a_randomized_controlled_trial