Effect of Collaborative Dementia Care via Telephone and Internet on Quality of Life, Caregiver Well-being, and Health Care Use

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Abstract

<p class="first" id="d4515117e313">Few health systems have adopted effective dementia care management programs. The Care Ecosystem is a model for delivering care from centralized hubs across broad geographic areas to caregivers and persons with dementia (PWDs) independently of their health system affiliations. </p>

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Most cited references 22

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Do multiple outcome measures require p-value adjustment?

Ronald Feise (2002)

Background Readers may question the interpretation of findings in clinical trials when multiple outcome measures are used without adjustment of the p-value. This question arises because of the increased risk of Type I errors (findings of false "significance") when multiple simultaneous hypotheses are tested at set p-values. The primary aim of this study was to estimate the need to make appropriate p-value adjustments in clinical trials to compensate for a possible increased risk in committing Type I errors when multiple outcome measures are used. Discussion The classicists believe that the chance of finding at least one test statistically significant due to chance and incorrectly declaring a difference increases as the number of comparisons increases. The rationalists have the following objections to that theory: 1) P-value adjustments are calculated based on how many tests are to be considered, and that number has been defined arbitrarily and variably; 2) P-value adjustments reduce the chance of making type I errors, but they increase the chance of making type II errors or needing to increase the sample size. Summary Readers should balance a study's statistical significance with the magnitude of effect, the quality of the study and with findings from other studies. Researchers facing multiple outcome measures might want to either select a primary outcome measure or use a global assessment measure, rather than adjusting the p-value.

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The Zarit Burden Interview

Sacha Dubois, Larry Squire, D. Molloy … (2001)

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Translating Evidence-Based Dementia Caregiving Interventions into Practice: State-of-the-Science and Next Steps.

Laura N Gitlin, Katherine Marx, Ian H Stanley … (2015)

Over the past 3 decades, more than 200 dementia caregiver interventions have been tested in randomized clinical trials and found to be efficacious. Few programs have been translated for delivery in various service contexts, and they remain inaccessible to the 15+ million dementia family caregivers in the United States. This article examines translational efforts and offers a vision for more rapid advancement in this area. We summarize the evidence for caregiver interventions, review published translational efforts, and recommend future directions to bridge the research-practice fissure in this area. We suggest that as caregiver interventions are tested external to service contexts, a translational phase is required. Yet, this is hampered by evidentiary gaps, lack of theory to understand implementation challenges, insufficient funding and unsupportive payment structures for sustaining programs. We propose ways to advance translational activities and future research with practical applications.

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Author and article information

Journal

Title: JAMA Internal Medicine

Abbreviated Title: JAMA Intern Med

Publisher: American Medical Association (AMA)

ISSN (Print): 2168-6106

Publication date (Electronic): September 30 2019

Affiliations

[1 ]Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco

[2 ]Global Brain Health Institute, University of California, San Francisco

[3 ]Home Instead Center for Successful Aging, Division of Geriatrics, Department of Internal Medicine, University of Nebraska Medical Center, Omaha

[4 ]Department of Clinical Pharmacy, University of California, San Francisco

[5 ]UCSF/UC Consortium on Law, Science & Health Policy, UC Hastings College of the Law, San Francisco

[6 ]Department of Epidemiology and Biostatistics, University of California, San Francisco

[7 ]Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco

[8 ]Division of Geriatrics, University of California, San Francisco

[9 ]Department of Social Work, Nebraska Wesleyan University, Lincoln

[10 ]Center for Research on Aging, San Francisco Campus for Jewish Living, San Francisco, California

Article

DOI: 10.1001/jamainternmed.2019.4101

PMC ID: 6777227

PubMed ID: 31566651

SO-VID: 9e655d0c-3463-4f8c-976a-d15e4f67dce6

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Effect of Collaborative Dementia Care via Telephone and Internet on Quality of Life, Caregiver Well-being, and Health Care Use : The Care Ecosystem Randomized Clinical Trial

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Most cited references 22

Do multiple outcome measures require p-value adjustment?

The Zarit Burden Interview

Translating Evidence-Based Dementia Caregiving Interventions into Practice: State-of-the-Science and Next Steps.

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