TY - JOUR
T1 - Occupational therapy for people with dementia and their family carers provided at home
T2 - A systematic review and meta-analysis
AU - Bennett, Sally
AU - Laver, Kate
AU - Voigt-Radloff, Sebastian
AU - Letts, Lori
AU - Clemson, Lindy
AU - Graff, Maud
AU - Wiseman, Jodie
AU - Gitlin, Laura
N1 - Publisher Copyright:
© 2019 Author(s).
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Objective To determine the effect of occupational therapy provided at home on activities of daily living, behavioural and psychological symptoms of dementia (BPSD) and quality of life (QOL) for people with dementia, and the effect on family carer burden, depression and QOL. Design Systematic review and meta-analysis. Methods Eight databases were searched to February 2018. Randomised controlled trials of occupational therapy delivered at home for people with dementia and their family carers that measured ADL, and/or BPSD were included. Two independent reviewers determined eligibility, risk of bias and extracted data. Results Fifteen trials were included (n=2063). Occupational therapy comprised multiple components (median=8 sessions). Compared with usual care or attention control occupational therapy resulted in improvements in the following outcomes for people with dementia: Overall ADL after intervention (standardised means difference (SMD) 0.61, 95% CI 0.16 to 1.05); instrumental ADL alone (SMD 0.22, 95% CI 0.07 to 0.37; moderate quality); number of behavioural and psychological symptoms (SMD-0.32, 95% CI-0.57 to-0.08; moderate quality); and QOL (SMD 0.76, 95% CI 0.28 to 1.24) after the intervention and at follow-up (SMD 1.07, 95% CI 0.58 to 1.55). Carers reported less hours assisting the person with dementia (SMD-0.33, 95% CI-0.58 to-0.07); had less distress with behaviours (SMD-0.23, 95% CI-0.42 to-0.05; moderate quality) and improved QOL (SMD 0.99, 95% CI 0.66 to 1.33; moderate quality). Two studies compared occupational therapy with a comparison intervention and found no statistically significant results. GRADE ratings indicated evidence was very low to moderate quality. Conclusions Findings suggest that occupational therapy provided at home may improve a range of important outcomes for people with dementia and their family carers. Health professionals could consider referring them for occupational therapy.
AB - Objective To determine the effect of occupational therapy provided at home on activities of daily living, behavioural and psychological symptoms of dementia (BPSD) and quality of life (QOL) for people with dementia, and the effect on family carer burden, depression and QOL. Design Systematic review and meta-analysis. Methods Eight databases were searched to February 2018. Randomised controlled trials of occupational therapy delivered at home for people with dementia and their family carers that measured ADL, and/or BPSD were included. Two independent reviewers determined eligibility, risk of bias and extracted data. Results Fifteen trials were included (n=2063). Occupational therapy comprised multiple components (median=8 sessions). Compared with usual care or attention control occupational therapy resulted in improvements in the following outcomes for people with dementia: Overall ADL after intervention (standardised means difference (SMD) 0.61, 95% CI 0.16 to 1.05); instrumental ADL alone (SMD 0.22, 95% CI 0.07 to 0.37; moderate quality); number of behavioural and psychological symptoms (SMD-0.32, 95% CI-0.57 to-0.08; moderate quality); and QOL (SMD 0.76, 95% CI 0.28 to 1.24) after the intervention and at follow-up (SMD 1.07, 95% CI 0.58 to 1.55). Carers reported less hours assisting the person with dementia (SMD-0.33, 95% CI-0.58 to-0.07); had less distress with behaviours (SMD-0.23, 95% CI-0.42 to-0.05; moderate quality) and improved QOL (SMD 0.99, 95% CI 0.66 to 1.33; moderate quality). Two studies compared occupational therapy with a comparison intervention and found no statistically significant results. GRADE ratings indicated evidence was very low to moderate quality. Conclusions Findings suggest that occupational therapy provided at home may improve a range of important outcomes for people with dementia and their family carers. Health professionals could consider referring them for occupational therapy.
KW - dementia
KW - geriatric medicine
KW - occupational therapy
KW - systematic review
UR - http://www.scopus.com/inward/record.url?scp=85074934106&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85074934106&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2018-026308
DO - 10.1136/bmjopen-2018-026308
M3 - Article
C2 - 31719067
AN - SCOPUS:85074934106
SN - 2044-6055
VL - 9
JO - BMJ open
JF - BMJ open
IS - 11
M1 - e026308
ER -