Internet-Based Supportive Interventions for Family Caregivers of People With Dementia: Systematic Review and Meta-Analysis

Minmin Leng, Yajie Zhao, Hongmei Xiao and 2 more

Journal of Medical Internet Research · 2020 · Meta-analysis

doi:10.2196/19468

Abstract

Background. Caring for people with dementia is perceived as one of the most stressful and difficult forms of caring. Family caregivers always experience high levels of psychological burden and physical strain, so effective and practical support is essential. Internet-based supportive interventions can provide convenient and efficient support and education to potentially reduce the physical and psychological burden associated with providing care.

Objective. This review aimed to (1) assess the efficacy of internet-based supportive interventions in ameliorating health outcomes for family caregivers of people with dementia, and (2) evaluate the potential effects of internet-based supportive intervention access by caregivers on their care recipients.

Methods. An electronic literature search of the PubMed, EMBASE, Web of Science, CINAHL, Cochrane Library, and PsycINFO databases was conducted up to January 2020. Two reviewers (ML and YZ) worked independently to identify randomized controlled trials (RCTs) that met the inclusion criteria and independently extracted data. The quality of the included RCTs was evaluated using the approach recommended by the Cochrane Handbook for Systematic Reviews of Interventions. Standardized mean differences (SMDs) with 95% CIs were applied to calculate the pooled effect sizes.

Results. In total, 17 RCTs met the eligibility criteria and were included in this systematic review. The meta-analysis showed that internet-based supportive interventions significantly ameliorated depressive symptoms (SMD=–0.21; 95% CI –0.31 to –0.10; P<.001), perceived stress (SMD=–0.40; 95% CI –0.55 to –0.24; P<.001), anxiety (SMD=–0.33; 95% CI –0.51 to –0.16; P<.001), and self-efficacy (SMD=0.19; 95% CI 0.05-0.33; P=.007) in dementia caregivers. No significant improvements were found in caregiver burden, coping competence, caregiver reactions to behavioral symptoms, or quality of life. Six studies assessed the unintended effects of internet-based supportive intervention access by caregivers on their care recipients. The results showed that internet-based supportive interventions had potential benefits on the quality of life and neuropsychiatric symptoms in care recipients.

Conclusions. Internet-based supportive interventions are generally effective at ameliorating depressive symptoms, perceived stress, anxiety, and self-efficacy in dementia caregivers and have potential benefits on care recipients. Future studies are encouraged to adopt personalized internet-based supportive interventions to improve the health of family caregivers and their care recipients.

Trial Registration. PROSPERO CRD42020162434; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=162434

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References 56

1.
Alzheimer’s Disease International (ADI). World Alzheimer Report 2018: The State of the Art of Dementia Research: New Frontiers. 2018.
Not in our library
2.
Wimo A. Establishing and funding long term care infrastructure. 2018;26-29.
Not in our library
3.
Drummond N, McCleary L, Garcia L, McGilton K, Molnar F, Dalziel W, Xu TJ, Turner D, Triscott J, Freiheit E. Assessing Determinants of Perceived Quality in Transitions for People with Dementia: a Prospective Observational Study. Can Geriatr J. 2019;22(1):13-22.
Not in our library10.5770/cgj.22.332
4.
Spigelmyer PC, Schreiber JB. A pilot study: Resistive behavior in the context of informal caregiver-assisted activities of daily living. Geriatr Nurs. 2019;40(4):399-404.
Not in our library10.1016/j.gerinurse.2019.01.005
5.
Huis In Het Veld Judith G, van Asch IFM, Willemse BM, Verkade P, Pot AM, Blom MM, Groot Zwaaftink RBM, Francke AL. Process Evaluation of Nurse-Led Online Self-Management Support for Family Caregivers to Deal With Behavior Changes of a Relative With Dementia (Part 1): Mixed Methods Study. J Med Internet Res. 2019;21(10):e13002.
Not in our library10.2196/13002
6.
The associations between behavioral-psychological symptoms of dementia (BPSD) and coping strategy, burden of care and personality style among low-income caregivers of patients with dementia · 2019
Not checked
7.
Zwingmann I, Hoffmann W, Michalowsky B, Dreier-Wolfgramm A, Hertel J, Wucherer D, Eichler T, Kilimann I, Thiel F, Teipel S, Thyrian JR. Supporting family dementia caregivers: testing the efficacy of dementia care management on multifaceted caregivers' burden. Aging Ment Health. 2018;22(7):889-896.
Not in our library10.1080/13607863.2017.1399341
8.
Tatangelo G, McCabe M, Macleod A, You E. "I just don't focus on my needs." The unmet health needs of partner and offspring caregivers of people with dementia: A qualitative study. Int J Nurs Stud. 2018;77:8-14.
Not in our library10.1016/j.ijnurstu.2017.09.011
9.
Jennings LA, Reuben DB, Evertson LC, Serrano KS, Ercoli L, Grill J, Chodosh J, Tan Z, Wenger NS. Unmet needs of caregivers of individuals referred to a dementia care program. J Am Geriatr Soc. 2015;63(2):282-9.
Not in our library10.1111/jgs.13251
10.
Peeters JM, Van Beek AP, Meerveld JH, Spreeuwenberg PM, Francke AL. Informal caregivers of persons with dementia, their use of and needs for specific professional support: a survey of the National Dementia Programme. BMC Nurs. 2010;9(1):9.
Not in our library10.1186/1472-6955-9-9
11.
Internet-Based Interventions Aimed at Supporting Family Caregivers of People With Dementia: Systematic Review · 2018
No notice
12.
Joling KJ, O'Dwyer ST, Hertogh CM, van Hout HP. The occurrence and persistence of thoughts of suicide, self-harm and death in family caregivers of people with dementia: a longitudinal data analysis over 2 years. Int J Geriatr Psychiatry. 2018;33(2):263-270.
Not in our library10.1002/gps.4708
13.
Alzheimer’s Disease International (ADI). World Alzheimer Report 2019: Attitudes to Dementia. 2019.
Not in our library
14.
Sepe-Monti M, Vanacore N, Bartorelli L, Tognetti A, Giubilei F, Caregiver Study Group Savvy. The Savvy Caregiver Program: A Probe Multicenter Randomized Controlled Pilot Trial in Caregivers of Patients Affected by Alzheimer's Disease. J Alzheimers Dis. 2016;54(3):1235-1246.
Not in our library10.3233/jad-160235
15.
Woods RT, Orrell M, Bruce E, Edwards RT, Hoare Z, Hounsome B, Keady J, Moniz-Cook E, Orgeta V, Rees J, Russell I. REMCARE: Pragmatic Multi-Centre Randomised Trial of Reminiscence Groups for People with Dementia and their Family Carers: Effectiveness and Economic Analysis. PLoS One. 2016;11(4):e0152843.
Not in our library10.1371/journal.pone.0152843
16.
The effect of psychosocial support on caregivers’ perceived criticism and emotional over-involvement of persons with dementia: an assessor-blinded randomized controlled trial · 2019
Not checked
17.
Hamieh N, Sharara E, Salibi N, Mrad P, Chaaya M. Public Knowledge of, Perceptions About and Attitudes Towards Dementia: A Cross-Sectional Survey Among Lebanese Primary Health Care Attenders. Community Ment Health J. 2019;55(8):1362-1368.
Not in our library10.1007/s10597-019-00436-2
18.
Brodaty H, Thomson C, Thompson C, Fine M. Why caregivers of people with dementia and memory loss don't use services. Int J Geriatr Psychiatry. 2005;20(6):537-46.
Not in our library10.1002/gps.1322
19.
How to explore the needs of informal caregivers of individuals with cognitive impairment in Alzheimer’s disease or related diseases? A systematic review of quantitative and qualitative studies · 2017
Not checked
20.
Lewis BA, Williams DM, Neighbors CJ, Jakicic JM, Marcus BH. Cost Analysis of Internet vs. Print Interventions for Physical Activity Promotion. Psychol Sport Exerc. 2010;11(3):246-249.
Not in our library10.1016/j.psychsport.2009.10.002
21.
Hayden LJ, Glynn SM, Hahn TJ, Randall F, Randolph E. The use of Internet technology for psychoeducation and support with dementia caregivers. Psychol Serv. 2012;9(2):215-8.
Not in our library10.1037/a0027056
22.
Ploeg J, Markle-Reid M, Valaitis R, McAiney C, Duggleby W, Bartholomew A, Sherifali D. Web-Based Interventions to Improve Mental Health, General Caregiving Outcomes, and General Health for Informal Caregivers of Adults With Chronic Conditions Living in the Community: Rapid Evidence Review. J Med Internet Res. 2017;19(7):e263.
Not in our library10.2196/jmir.7564
23.
Sherifali D, Ali MU, Ploeg J, Markle-Reid M, Valaitis R, Bartholomew A, Fitzpatrick-Lewis D, McAiney C. Impact of Internet-Based Interventions on Caregiver Mental Health: Systematic Review and Meta-Analysis. J Med Internet Res. 2018;20(7):e10668.
Not in our library10.2196/10668
24.
Ploeg J, Ali MU, Markle-Reid M, Valaitis R, Bartholomew A, Fitzpatrick-Lewis D, McAiney C, Sherifali D. Caregiver-Focused, Web-Based Interventions: Systematic Review and Meta-Analysis (Part 2). J Med Internet Res. 2018;20(10):e11247.
Not in our library10.2196/11247
25.
Beauchamp N, Irvine AB, Seeley J, Johnson B. Worksite-based internet multimedia program for family caregivers of persons with dementia. Gerontologist. 2005;45(6):793-801.
Not in our library10.1093/geront/45.6.793
26.
Gustafson DH, Gustafson DH, Cody OJ, Chih M, Johnston DC, Asthana S. Pilot Test of a Computer-Based System to Help Family Caregivers of Dementia Patients. J Alzheimers Dis. 2019;70(2):541-552.
Not in our library10.3233/jad-190052
27.
Núñez-Naveira L, Alonso-Búa B, de Labra C, Gregersen R, Maibom K, Mojs E, Krawczyk-Wasielewska A, Millán-Calenti JC. UnderstAID, an ICT Platform to Help Informal Caregivers of People with Dementia: A Pilot Randomized Controlled Study. Biomed Res Int. 2016;2016:5726465.
Not in our library10.1155/2016/5726465
28.
Van Mierlo LD, Meiland FJ, Van de Ven PM, Van Hout HP, Dröes R-M. Evaluation of DEM-DISC, customized e-advice on health and social support services for informal carers and case managers of people with dementia; a cluster randomized trial. Int Psychogeriatr. 2015;27(8):1365-78.
Not in our library10.1017/s1041610215000423
29.
A Web-Based Psychoeducational Program for Informal Caregivers of Patients With Alzheimer’s Disease: A Pilot Randomized Controlled Trial · 2015
No notice
30.
Meichsner F, Theurer C, Wilz G. Acceptance and treatment effects of an internet-delivered cognitive-behavioral intervention for family caregivers of people with dementia: A randomized-controlled trial. J Clin Psychol. 2019;75(4):594-613.
Not in our library10.1002/jclp.22739
31.
Kajiyama B, Thompson LW, Eto-Iwase T, Yamashita M, Di Mario John, Marian Tzuang Yuan, Gallagher-Thompson D. Exploring the effectiveness of an internet-based program for reducing caregiver distress using the iCare Stress Management e-Training Program. Aging Ment Health. 2013;17(5):544-54.
Not in our library10.1080/13607863.2013.775641
32.
McKechnie V, Barker C, Stott J. Effectiveness of computer-mediated interventions for informal carers of people with dementia-a systematic review. Int Psychogeriatr. 2014;26(10):1619-37.
Not in our library10.1017/s1041610214001045
33.
Zhao Y, Feng H, Hu M, Hu H, Li H, Ning H, Chen H, Liao L, Peng L. Web-Based Interventions to Improve Mental Health in Home Caregivers of People With Dementia: Meta-Analysis. J Med Internet Res. 2019;21(5):e13415.
Not in our library10.2196/13415
34.
Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.
Not in our library10.1136/bmj.b2535
35.
Deeks JH, Altman D. Assessing risk of bias in included studies. Cochrane Handbook for Systematic Reviews of Interventions. 2008;211-242.
Not in our library
36.
Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557-60.
Not in our library10.1136/bmj.327.7414.557
37.
Effectiveness of an Internet Intervention for Family Caregivers of People with Dementia: Results of a Randomized Controlled Trial · 2015
No notice
38.
Brennan PF, Moore SM, Smyth KA. The effects of a special computer network on caregivers of persons with Alzheimer's disease. Nurs Res. 1995;44(3):166-72.
Not in our library
39.
Duggleby W, Ploeg J, McAiney C, Peacock S, Fisher K, Ghosh S, Markle-Reid M, Swindle J, Williams A, Triscott JA, Forbes D, Jovel Ruiz K. Web-Based Intervention for Family Carers of Persons with Dementia and Multiple Chronic Conditions (My Tools 4 Care): Pragmatic Randomized Controlled Trial. J Med Internet Res. 2018;20(6):e10484.
Not in our library10.2196/10484
40.
Web-Based STAR E-Learning Course Increases Empathy and Understanding in Dementia Caregivers: Results from a Randomized Controlled Trial in the Netherlands and the United Kingdom · 2015
No notice
41.
Hicken BL, Daniel C, Luptak M, Grant M, Kilian S, Rupper RW. Supporting Caregivers of Rural Veterans Electronically (SCORE). J Rural Health. 2017;33(3):305-313.
Not in our library10.1111/jrh.12195
42.
Kales HC, Gitlin LN, Stanislawski B, Myra Kim H, Marx K, Turnwald M, Chiang C, Lyketsos CG. Effect of the WeCareAdvisor™ on family caregiver outcomes in dementia: a pilot randomized controlled trial. BMC Geriatr. 2018;18(1):113.
Not in our library10.1186/s12877-018-0801-8
43.
Metcalfe A, Jones B, Mayer J, Gage H, Oyebode J, Boucault S, Aloui S, Schwertel U, Böhm M, Tezenas du Montcel S, Lebbah S, De Mendonça A, De Vugt M, Graff C, Jansen S, Hergueta T, Dubois B, Kurz A. Online information and support for carers of people with young-onset dementia: A multi-site randomised controlled pilot study. Int J Geriatr Psychiatry. 2019;34(10):1455-1464.
Not in our library10.1002/gps.5154
44.
Possin KL, Merrilees JJ, Dulaney S, Bonasera SJ, Chiong W, Lee K, Hooper SM, Allen IE, Braley T, Bernstein A, Rosa TD, Harrison K, Begert-Hellings H, Kornak J, Kahn JG, Naasan G, Lanata S, Clark AM, Chodos A, Gearhart R, Ritchie C, Miller BL. Effect of Collaborative Dementia Care via Telephone and Internet on Quality of Life, Caregiver Well-being, and Health Care Use. JAMA Intern Med. 2019;179(12):1658.
Not in our library10.1001/jamainternmed.2019.4101
45.
Torkamani M, McDonald L, Saez Aguayo I, Kanios C, Katsanou M, Madeley L, Limousin PD, Lees AJ, Haritou M, Jahanshahi M, ALADDIN Collaborative Group. A randomized controlled pilot study to evaluate a technology platform for the assisted living of people with dementia and their carers. J Alzheimers Dis. 2014;41(2):515-23.
Not in our library10.3233/jad-132156
46.
Williams K, Perkhounkova Y, Shaw C, Hein M, Vidoni E, Coleman C. Supporting Family Caregivers With Technology for Dementia Home Care: A Randomized Controlled Trial. Innov Aging. 2019;3(3):igz037.
Not in our library10.1093/geroni/igz037
47.
American Geriatrics Society Expert Panel on Person-Centered Care T. Person-Centered Care: A Definition and Essential Elements. J Am Geriatr Soc. 2016;64(1):15-8.
Not in our library10.1111/jgs.13866
48.
National Institute for Health and Care Excellence (UK). National Institute for Health and Care Excellence: Clinical Guidelines. Dementia: Assessment, Management and Support for People Living With Dementia and Their Carers. 2018.
Not in our library
49.
Fazio S, Pace D, Maslow K, Zimmerman S, Kallmyer B. Alzheimer's Association Dementia Care Practice Recommendations. Gerontologist. 2018;58(suppl_1):S1-S9.
Not in our library10.1093/geront/gnx182
50.
Australian and New Zealand Society for Geriatric Medicine. Position Statement 26 Management of Behavioural and Psychological Symptoms of Dementia (BPSD). 2016.
Not in our library
51.
Dauphinot V, Ravier A, Novais T, Delphin-Combe F, Mouchoux C, Krolak-Salmon P. Risk Factors of Caregiver Burden Evolution, for Patients With Subjective Cognitive Decline or Neurocognitive Disorders: A Longitudinal Analysis. J Am Med Dir Assoc. 2016;17(11):1037-1043.
Not in our library10.1016/j.jamda.2016.07.003
52.
Swinkels J, Broese van Groenou Marjolein I, de Boer Alice, Tilburg T. Male and Female Partner-Caregivers' Burden: Does It Get Worse Over Time? Gerontologist. 2019;59(6):1103-1111.
Not in our library10.1093/geront/gny132
53.
Morrin H, Fang T, Servant D, Aarsland D, Rajkumar AP. Systematic review of the efficacy of non-pharmacological interventions in people with Lewy body dementia. Int. Psychogeriatr. 2017;30(3):395-407.
Not in our library10.1017/s1041610217002010
54.
Caspar S, Davis ED, Douziech A, Scott DR. Nonpharmacological Management of Behavioral and Psychological Symptoms of Dementia: What Works, in What Circumstances, and Why? Innov Aging. 2018;2(1):igy001.
Not in our library10.1093/geroni/igy001
55.
A meta-review of stress, coping and interventions in dementia and dementia caregiving · 2016
No notice
56.
Schaller S, Marinova-Schmidt V, Gobin J, Criegee-Rieck M, Griebel L, Engel S, Stein V, Graessel E, Kolominsky-Rabas PL. Tailored e-Health services for the dementia care setting: a pilot study of 'eHealthMonitor'. BMC Med Inform Decis Mak. 2015;15:58.
Not in our library10.1186/s12911-015-0182-2

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