Therapeutic Education in a dyadic approach to Alzheimer's disease
Helene Villars
Geriatric Department Toulouse University Hospital, France
: J Nurs Patient Care
Abstract
Statement of the Problem: Alzheimer’s disease (AD) is a major public health issue in Western societies. Non-pharmacological therapies are at the forefront of therapeutic strategies du to the current lack of pharmacological treatment. The purpose of this study was to assess the impact of an educational intervention called Therapeutic Patient Education (TPE) on the AD patient’s quality of life, conducted in a dyadic approach (patient/caregiver) Methodology & Theoretical Orientation: This randomized, single-blind, monocentric controlled trial, called THREAD (Therapeutic Education in Alzheimer’s Disease) was conducted in the Toulouse University Hospital in the south of France between 01.01 /2013 and 31.12/2016. THREAD involved 196 patients and their caregivers (196 dyads), 98 in the intervention group (a structured TPE intervention, with individual sessions for patients and caregivers and group sessions only for caregivers), and 98 in the control group, both followed by one year. The primary outcome was the AD patients’ Quality of life (QOL) on the QOL Logsdon scale proxy reported by a caregiver. Secondary outcomes were the AD patients’ QOL self-rated, behavioural and psychological symptoms, autonomy, caregivers’ burden, and QOL. Findings: The AD patients’ QOL was not improved when proxy reported by the caregiver but significatively improved when self-reported by the patient. We did not retrieve any impact of the intervention on other secondary outcomes. Conclusion & Significance: Despite the possible methodological bias, this result underlines the challenging issue of the QOL assessment and the importance of a double perspective in AD. Recent literature reports the effects of educational intervention when included in a multicomponent intervention (psychological support, respite care). Moreover, the dyadic approach is now widely used (3). A dyadic approach in both intervention and assessment seems innovative and inclusive. Among exhausted caregivers, we retrieved a positive effect of TPE. Thus, the caregiver burden could be the target of future educational interventions. The patient’s AD patient’s QOL remains a multidimensional relevant criterion. Keywords: teleservice, videoconferencing, video monitoring, digital photography, telecommunication, nursing.
Biography
Dr. Hélène Villars is a French physician, and geriatrician, at the Geriatric Department of the Toulouse University Hospital. She earned an MD degree in Geriatrics from Toulouse University and is currently finishing his Ph.D. in Public Health on nonpharmacological intervention such as educational intervention addressed to the dyad (patient/caregivers) in Alzheimer’s disease. She is a member of the French Society of Geriatrics In her daily clinical activity at the Toulouse University Hospital. Dr. Villars is the head of a day-care hospital and a support platform for nursing home residents during the COVID period.
