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Effectiveness of a training package for implementing a community-based occupational therapy program in dementia: a cluster randomized controlled trial.

Abstract

OBJECTIVE

Evaluate the effectiveness of a training package to implement a community occupational therapy program for people with dementia and their caregiver (COTiD).

DESIGN

Cluster randomized controlled trial.

SUBJECTS

A total of 45 service units including 94 occupational therapists, 48 managers, 80 physicians, treating 71 client-caregiver couples.

INTERVENTIONS

Control intervention: A postgraduate course for occupational therapists only.

EXPERIMENTAL INTERVENTION

A training package including the usual postgraduate course, additional training days, outreach visits, regional meetings, and access to a reporting system for occupational therapists. Physicians and managers received newsletters, had access to a website, and were approached by telephone.

MAIN MEASURES

PRIMARY OUTCOME

The intended adherence of therapists to the COTiD program. This was assessed using vignettes.

SECONDARY OUTCOMES

clients' daily functioning, caregivers' sense of competence, quality of life, and self-perceived performance of daily activities of both clients and caregivers. Between-group differences were assessed using multilevel analyses with therapist and intervention factors as covariates.

RESULTS

No significant between-group differences between baseline and 12 months were found for adherence (1.58, 95% CI -0.10 to 3.25), nor for any client or caregiver outcome. A higher number of coaching sessions and higher self-perceived knowledge of dementia at baseline positively correlated with adherence scores. In contrast, experiencing more support from occupational therapy colleagues or having conducted more COTiD treatments at baseline negatively affected adherence scores.

CONCLUSION

The training package was not effective in increasing therapist adherence and client-caregiver outcomes. This study suggests that coaching sessions and increasing therapist knowledge on dementia positively affect adherence.

CLINICAL TRIAL NUMBER

NCT01117285.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Radboud University Medical Center, Scientific Institute for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands The Nijmegen Alzheimer Centre, Nijmegen, The Netherlands carola.dopp@tno.nl.

    ,

    Radboud University Medical Center, Scientific Institute for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands The Nijmegen Alzheimer Centre, Nijmegen, The Netherlands Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands.

    ,

    Department for Health Evidence (Biostatistics section), Radboud University Medical Center, Nijmegen, The Netherlands.

    ,

    The Nijmegen Alzheimer Centre, Nijmegen, The Netherlands Department of Geriatrics, Radboud University Medical Center, Nijmegen, The Netherlands.

    ,

    Radboud University Medical Center, Scientific Institute for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands.

    Radboud University Medical Center, Scientific Institute for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands The Nijmegen Alzheimer Centre, Nijmegen, The Netherlands Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands Kalorama Foundation, Beek-Ubbergen, The Netherlands.

    Source

    Clinical rehabilitation 29:10 2015 Oct pg 974-86

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Caregivers
    Cluster Analysis
    Community Health Services
    Dementia
    Education, Graduate
    Female
    Guideline Adherence
    Health Personnel
    Humans
    Male
    Middle Aged
    Multilevel Analysis
    Netherlands
    Occupational Therapy
    Patient Care Team
    Professional-Family Relations

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    25547113

    Citation

    Döpp, Carola M E., et al. "Effectiveness of a Training Package for Implementing a Community-based Occupational Therapy Program in Dementia: a Cluster Randomized Controlled Trial." Clinical Rehabilitation, vol. 29, no. 10, 2015, pp. 974-86.
    Döpp CM, Graff MJ, Teerenstra S, et al. Effectiveness of a training package for implementing a community-based occupational therapy program in dementia: a cluster randomized controlled trial. Clin Rehabil. 2015;29(10):974-86.
    Döpp, C. M., Graff, M. J., Teerenstra, S., Olde Rikkert, M. G., Nijhuis-van der Sanden, M. W., & Vernooij-Dassen, M. J. (2015). Effectiveness of a training package for implementing a community-based occupational therapy program in dementia: a cluster randomized controlled trial. Clinical Rehabilitation, 29(10), pp. 974-86. doi:10.1177/0269215514564699.
    Döpp CM, et al. Effectiveness of a Training Package for Implementing a Community-based Occupational Therapy Program in Dementia: a Cluster Randomized Controlled Trial. Clin Rehabil. 2015;29(10):974-86. PubMed PMID: 25547113.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effectiveness of a training package for implementing a community-based occupational therapy program in dementia: a cluster randomized controlled trial. AU - Döpp,Carola M E, AU - Graff,Maud J L, AU - Teerenstra,Steven, AU - Olde Rikkert,Marcel G M, AU - Nijhuis-van der Sanden,Maria W G, AU - Vernooij-Dassen,Myrra J F J, Y1 - 2014/12/28/ PY - 2013/12/10/received PY - 2014/11/22/accepted PY - 2014/12/31/entrez PY - 2014/12/31/pubmed PY - 2016/6/28/medline KW - Adherence KW - caregiver KW - cost-effectiveness KW - dementia KW - implementation KW - manager KW - occupational therapy KW - physician SP - 974 EP - 86 JF - Clinical rehabilitation JO - Clin Rehabil VL - 29 IS - 10 N2 - OBJECTIVE: Evaluate the effectiveness of a training package to implement a community occupational therapy program for people with dementia and their caregiver (COTiD). DESIGN: Cluster randomized controlled trial. SUBJECTS: A total of 45 service units including 94 occupational therapists, 48 managers, 80 physicians, treating 71 client-caregiver couples. INTERVENTIONS: Control intervention: A postgraduate course for occupational therapists only. EXPERIMENTAL INTERVENTION: A training package including the usual postgraduate course, additional training days, outreach visits, regional meetings, and access to a reporting system for occupational therapists. Physicians and managers received newsletters, had access to a website, and were approached by telephone. MAIN MEASURES: PRIMARY OUTCOME: The intended adherence of therapists to the COTiD program. This was assessed using vignettes. SECONDARY OUTCOMES: clients' daily functioning, caregivers' sense of competence, quality of life, and self-perceived performance of daily activities of both clients and caregivers. Between-group differences were assessed using multilevel analyses with therapist and intervention factors as covariates. RESULTS: No significant between-group differences between baseline and 12 months were found for adherence (1.58, 95% CI -0.10 to 3.25), nor for any client or caregiver outcome. A higher number of coaching sessions and higher self-perceived knowledge of dementia at baseline positively correlated with adherence scores. In contrast, experiencing more support from occupational therapy colleagues or having conducted more COTiD treatments at baseline negatively affected adherence scores. CONCLUSION: The training package was not effective in increasing therapist adherence and client-caregiver outcomes. This study suggests that coaching sessions and increasing therapist knowledge on dementia positively affect adherence. CLINICAL TRIAL NUMBER: NCT01117285. SN - 1477-0873 UR - https://www.unboundmedicine.com/medline/citation/25547113/Effectiveness_of_a_training_package_for_implementing_a_community_based_occupational_therapy_program_in_dementia:_a_cluster_randomized_controlled_trial_ L2 - http://journals.sagepub.com/doi/full/10.1177/0269215514564699?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -