A pilot randomized controlled trial of a self-management group intervention for people with early-stage dementia (The SMART study)

Quinn, Catherine; Toms, Gill; Jones, Carys; Brand, Andrew; Edwards, Rhiannon Tudor; Sanders, Fiona L.; Clare, Linda

doi:10.1017/s1041610215002094

Cited by 83 publications

(82 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, there is On the other hand, there is a growing interest for self-management in dementia, and the views of people with dementia being unable to learn new skills are being challenged (Mountain, 2006). The small number of studies being conducted in the area has shown promising results for participant's general wellbeing and sense of self-efficacy (see for example Quinn et al 2016b;Sprange et al 2015;Hickman, Wiersma & Harvey, 2015;Laakkonen, Kautiainen, Hölttä, Saivikko, Tilvis & Strandberg et al 2016). …”

Section: Meaningful Activities and Relationshipsmentioning

confidence: 99%

Living Life and Doing Things Together: Collaborative Research With Couples Where One Partner Has a Diagnosis of Dementia

et al. 2018

View full text Add to dashboard Cite

The aim of this study is to identify relevant content for a self-management guide by using the outcomes of previous research in combination with knowledge and experiences from couples where one partner has a diagnosis of dementia. The study was carried out in three phases: 1) Literature search of previous research related to wellbeing and couplehood in dementia; 2) Interviews with couples with dementia based on the findings of the literature search; 3) Further authentication of the findings within expert groups of people with dementia and carers. For analysis of data we used a hybrid approach of thematic analysis with combined deductive and inductive approaches. The findings of this study indicated that the four main themes "Home and Neighborhood", "Meaningful activities and Relationships", "Approach and Empowerment" and "Couplehood" with related sub themes could be appropriate targets for a self-management guide for couples where one partner has a diagnosis of dementia.

show abstract

Section: Meaningful Activities and Relationshipsmentioning

confidence: 99%

Living Life and Doing Things Together: Collaborative Research With Couples Where One Partner Has a Diagnosis of Dementia

et al. 2018

View full text Add to dashboard Cite

show abstract

“…We found 10 studies 37,59,62,106,109,110,115,121,132,136 looking at SM interventions for people living with dementia or cognitive impairment, only one of which included people with dementia and diabetes. 59 This controlled study evaluated the impact of personalised education sessions on people with diabetes and cognitive impairment.…”

Section: Stigma and Barriers To Care For People Living With Dementiamentioning

confidence: 99%

“…147 This literature does, however, provide valuable insights into what needs to be in place to support independence and appropriate outcomes in people living with dementia, much of which might form the basis for programmes for people with dementia and diabetes. Potentially important components of such programmes include the need to focus on the abilities and strengths of people with dementia rather than their disabilities, 109,110 on emotions rather than problems, 109 on building confidence 62,121 and on respecting participant autonomy and enhancing empowerment. 106 Social interaction may also be important.…”

Section: Stigma and Barriers To Care For People Living With Dementiamentioning

confidence: 99%

“…106 Social interaction may also be important. 106,110,143 A small feasibility study 121 suggested that SM interventions may foster independence and reciprocity, and promote social and clinical support. A larger RCT involving 136 people living with dementia-spouse dyads found that a group-based intervention to promote SM in people newly diagnosed with dementia led to improvements in health-related quality of life in spouses and in cognition in people living with dementia, although quality-of-life improvements in spouses were not maintained at longer-term (9-month) follow-up.…”

Section: Stigma and Barriers To Care For People Living With Dementiamentioning

confidence: 99%

See 1 more Smart Citation

Managing diabetes in people with dementia: a realist review

Bunn

Goodman

Jones

et al. 2017

Health Technol Assess

View full text Add to dashboard Cite

BackgroundDementia and diabetes mellitus are common long-term conditions that coexist in a large number of older people. People living with dementia and diabetes may be at increased risk of complications such as hypoglycaemic episodes because they are less able to manage their diabetes.ObjectivesTo identify the key features or mechanisms of programmes that aim to improve the management of diabetes in people with dementia and to identify areas needing further research.DesignRealist review, using an iterative, stakeholder-driven, four-stage approach. This involved scoping the literature and conducting stakeholder interviews to develop initial programme theories, systematic searches of the evidence to test and develop the theories, and the validation of programme theories with a purposive sample of stakeholders.ParticipantsTwenty-six stakeholders (user/patient representatives, dementia care providers, clinicians specialising in dementia or diabetes and researchers) took part in interviews and 24 participated in a consensus conference.Data sourcesThe following databases were searched from 1990 to March 2016: MEDLINE (PubMed), Cumulative Index to Nursing and Allied Health Literature, Scopus, The Cochrane Library (including the Cochrane Database of Systematic Reviews), Database of Abstracts of Reviews of Effects, the Health Technology Assessment (HTA) database, NHS Economic Evaluation Database, AgeInfo (Centre for Policy on Ageing – UK), Social Care Online, the National Institute for Health Research (NIHR) portfolio database, NHS Evidence, Google (Google Inc., Mountain View, CA, USA) and Google Scholar (Google Inc., Mountain View, CA, USA).ResultsWe included 89 papers. Ten papers focused directly on people living with dementia and diabetes, and the rest related to people with dementia or diabetes or other long-term conditions. We identified six context–mechanism–outcome (CMO) configurations that provide an explanatory account of how interventions might work to improve the management of diabetes in people living with dementia. This includes embedding positive attitudes towards people living with dementia, person-centred approaches to care planning, developing skills to provide tailored and flexible care, regular contact, family engagement and usability of assistive devices. A general metamechanism that emerges concerns the synergy between an intervention strategy, the dementia trajectory and social and environmental factors, especially family involvement. A flexible service model for people with dementia and diabetes would enable this synergy in a way that would lead to the improved management of diabetes in people living with dementia.LimitationsThere is little evidence relating to the management of diabetes in people living with dementia, although including a wider literature provided opportunities for transferable learning. The outcomes in our CMOs are largely experiential rather than clinical. This reflects the evidence available. Outcomes such as increased engagement in self-management are potential surrogates for better clinical management of diabetes, but this is not proven.ConclusionsThis review suggests that there is a need to prioritise quality of life, independence and patient and carer priorities over a more biomedical, target-driven approach. Much current research, particularly that specific to people living with dementia and diabetes, identifies deficiencies in, and problems with, current systems. Although we have highlighted the need for personalised care, continuity and family-centred approaches, there is much evidence to suggest that this is not currently happening. Future research on the management of diabetes in older people with complex health needs, including those with dementia, needs to look at how organisational structures and workforce development can be better aligned to the needs of people living with dementia and diabetes.Study registrationThis study is registered as PROSPERO CRD42015020625.FundingThe NIHR HTA programme.

show abstract

“…The PRIDE study comprises five interrelated strands investigating early/mild dementia. The first two strands involved an epidemiological investigation into the risk and protective factors associated with dementia in two large longitudinal databases of older adults in England and Brazil (11) and a qualitative exploration of social discourses of dementia focusing on the themes of memory and independence, involving interviews and observations with adults ranging from those with no memory problems to those two years post diagnosis (12). These two studies contributed to the development of the PRIDE intervention, along with existing literature, which was then tested to inform present feasibility randomised controlled trial.…”

Section: Introductionmentioning

confidence: 99%

Promoting Independence in Dementia (PRIDE): Protocol for a Feasibility Randomised Controlled Trial

Shafayat

Csipke

Bradshaw

et al. 2019

Preprint

View full text Add to dashboard Cite

Background Memory services often see people with early stage dementia who are largely independent and able to participate in community activities but who run the risk of reducing activities and social networks. PRIDE is a self-management intervention designed to promote living well and enhance independence for people with mild dementia. This study aims to examine the feasibility of conducting a definitive randomised trial comparing the clinical and cost-effectiveness of the PRIDE intervention offered in addition to usual care or with usual care alone. Methods/Design PRIDE is a parallel, two-arm, multicentre, feasibility, randomised controlled trial (RCT). Eligible participants aged 18 or over who have mild dementia (defined as a score of 0.5 or 1 on the Clinical Dementia Rating Scale) who can participate in the intervention and provide informed consent will be randomised (1:1) to treatment with the PRIDE intervention delivered in addition to usual care, or usual care only. Participants will be followed-up at three and six month’s post-randomisation. There will be an option for a supporter to join each participant. Each supporter will be provided with questionnaires at baseline and follow-ups at three to six months. Embedded qualitative research with both participants and supporters will explore their perspectives on the intervention investigating a range of themes including acceptability and barriers and facilitators to delivery and participation. The feasibility of conducting a full RCT associated with participant recruitment and follow-up of both conditions, intervention delivery including the recruitment, training, retention of PRIDE trained facilitators, clinical outcomes, intervention and resource use costs and the acceptability of the intervention and study related procedures will be examined. Discussion This study will assess whether a definitive randomised trial comparing the clinical and cost-effectiveness of whether the PRIDE intervention offered in addition to usual care is feasible in comparison to usual care alone, and if so will provide data to inform the design and conduct of a future trial. Trial Registration and protocol version ISRCTN, ISRCTN11288961, registered on 23 October 2019, http://www.isrctn.com/ISRCTN12345678 Protocol V2.1 dated 19 June 2019 Keywords Dementia, self-management, feasibility trial

show abstract

A pilot randomized controlled trial of a self-management group intervention for people with early-stage dementia (The SMART study)

Abstract: Background: Self-management equips people to manage the symptoms and lifestyle

Cited by 83 publications

References 21 publications

Living Life and Doing Things Together: Collaborative Research With Couples Where One Partner Has a Diagnosis of Dementia

Living Life and Doing Things Together: Collaborative Research With Couples Where One Partner Has a Diagnosis of Dementia

Managing diabetes in people with dementia: a realist review

Promoting Independence in Dementia (PRIDE): Protocol for a Feasibility Randomised Controlled Trial

Contact Info

Product

Resources

About