Feasibility and acceptability of NIDUS-professional, a training and support intervention for homecare workers caring for clients living with dementia: a cluster-randomised feasibility trial

In the first randomised controlled trial of a dementia training and support intervention in UK homecare agencies, we aimed to assess: acceptability of our co-designed, manualised training, delivered by non-clinical facilitators; outcome completion feasibility; and costs for a future trial. This clus...

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Published in:Age and ageing 2024-04, Vol.53 (4)
Main Authors: Cooper, Claudia, Zabihi, Sedigheh, Akhtar, Amirah, Lee, Teresa, Isaaq, Abdinasir, Le Novere, Marie, Barber, Julie, Lord, Kathryn, Rapaport, Penny, Banks, Sara, Duggan, Sandra, Ogden, Margaret, Walters, Kate, Orgeta, Vasiliki, Rockwood, Kenneth, Butler, Laurie T, Manthorpe, Jill, Dow, Briony, Hoe, Juanita, Hunter, Rachael, Banerjee, Sube, Budgett, Jessica, Duffy, Larisa
Format: Article
Language:English
Subjects:
Caregivers - psychology
Clinical Trial
Dementia - diagnosis
Dementia - therapy
Feasibility Studies
Humans
Quality of Life
Single-Blind Method
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Summary:In the first randomised controlled trial of a dementia training and support intervention in UK homecare agencies, we aimed to assess: acceptability of our co-designed, manualised training, delivered by non-clinical facilitators; outcome completion feasibility; and costs for a future trial. This cluster-randomised (2:1) single-blind, feasibility trial involved English homecare agencies. Intervention arm agency staff were offered group videocall sessions: 6 over 3 months, then monthly for 3 months (NIDUS-professional). Family carers (henceforth carers) and clients with dementia (dyads) were offered six to eight complementary, individual intervention sessions (NIDUS-Family). We collected potential trial measures as secondary outcomes remotely at baseline and 6 months: HCW (homecare worker) Work-related Strain Inventory (WRSI), Sense of Competence (SoC); proxy-rated Quality of Life (QOL), Disability Assessment for Dementia scale (DAD), Neuropsychiatric Inventory (NPI) and Homecare Satisfaction (HCS). From December 2021 to September 2022, we met agency (4 intervention, 2 control) and HCWs (n = 62) recruitment targets and recruited 16 carers and 16/60 planned clients. We met a priori progression criteria for adherence (≥4/6 sessions: 29/44 [65.9%,95% confidence interval (CI): 50.1,79.5]), HCW or carer proxy-outcome completion (15/16 (93.8% [69.8,99.8]) and proceeding with adaptation for HCWs outcome completion (46/63 (73.0% [CI: 60.3,83.4]). Delivery of NIDUS-Professional costs was £6,423 (£137 per eligible client). WRSI scores decreased and SoC increased at follow-up, with no significant between-group differences. For intervention arm proxy-rated outcomes, carer-rated QOL increased, HCW-rated was unchanged; carer and HCW-rated NPI decreased; DAD decreased (greater disability) and HCS was unchanged. A pragmatic trial is warranted; we will consider using aggregated, agency-level client outcomes, including neuropsychiatric symptoms.
ISSN:0002-0729
1468-2834
1468-2834
DOI:10.1093/ageing/afae074