Feasibility of Telehealth Occupational Therapy for Behavioral Symptoms of Adults With Dementia: Randomized Controlled Trial-Reference-Cited by-同舟云学术

Feasibility of Telehealth Occupational Therapy for Behavioral Symptoms of Adults With Dementia: Randomized Controlled Trial

Published:2023-07-01 Issue:4 Volume:77 Page:
ISSN:0272-9490
Container-title:The American Journal of Occupational Therapy
language:en
Short-container-title:

Author:

Rhodus Elizabeth K.¹,Baum Carolyn²,Kryscio Richard³,Liu Changrui⁴,George Rosmy⁵,Thompson MaryEllen⁶,Lowry Kimberly⁷,Coy Beth⁸,Barber Justin⁹,Nichols Heather¹⁰,Curtis Alexandra¹¹,Holloman Angela¹²,Jicha Gregory A.¹³

Affiliation:

1. Elizabeth K. Rhodus, PhD, OTR/L, is Assistant Professor, Sanders-Brown Center on Aging and Department of Behavioral Science, University of Kentucky, Lexington; elizabeth.rhodus@uky.edu

2. Carolyn Baum, PhD, OTR/L, FAOTA, is Professor, Program in Occupational Therapy, Washington University in St. Louis, St. Louis, MO.

3. Richard Kryscio, PhD, is Professor, Sanders-Brown Center on Aging and Department of Statistics, University of Kentucky, Lexington.

4. Changrui Liu, MS, is Graduate Assistant, Department of Statistics, University of Kentucky, Lexington.

5. Rosmy George, MS, BS, CCRP, is Clinical Trial Coordinator, Sanders-Brown Center on Aging, University of Kentucky, Lexington.

6. MaryEllen Thompson, PhD, OTR/L, is Retired Professor, Department of Occupational Science and Occupational Therapy, Eastern Kentucky University, Richmond.

7. Kimberly Lowry, APRN, is Clinician, Sanders-Brown Center on Aging, University of Kentucky, Lexington.

8. Beth Coy, APRN, is Clinician, Sanders-Brown Center on Aging, University of Kentucky, Lexington.

9. Justin Barber, MS, CCRP, is Alzheimer’s Disease Research Center & Affiliated Studies Team Leader, Sanders-Brown Center on Aging, University of Kentucky, Lexington.

10. Heather Nichols, BS, CCRP, is Administrative Research Assistant Senior, Sanders-Brown Center on Aging, University of Kentucky, Lexington.

11. Alexandra Curtis, MPH, CCRP, is Clinical Trials Research Manager, Sanders-Brown Center on Aging, University of Kentucky, Lexington.

12. Angela Holloman, BS, is Program Manager Senior, Sanders-Brown Center on Aging, University of Kentucky, Lexington.

13. Gregory A. Jicha, MD, PhD, is Professor, Sanders-Brown Center on Aging and Department of Neurology, University of Kentucky, Lexington.

Abstract

Abstract Importance: Supporting community residency of adults with Alzheimer’s disease (AD) is a critical public health initiative. Occupational therapy can contribute to this goal. Objective: To assess the feasibility of a novel telehealth intervention to support occupational engagement in community-residing people with AD. Design: Single-blind, three-arm, parallel, randomized controlled trial. Setting: Occupational therapy delivered through telehealth in participants’ homes. Participants: People with AD who reside in the community with behavioral symptoms and their care partners (dyads). Interventions: (1) HARMONY (Helping older Adults cReate & Manage OccupatioNs successfully), a telehealth intervention that applies principles of individualized guided discovery with environmental cueing for caregivers of persons with AD to promote activity participation and manage behavioral symptoms; (2) standardized training regarding the use of a sensory-based approach in dementia care; and (3) a control, including home safety education and weekly monitoring of behaviors. Outcomes and Measures: Feasibility was assessed as the primary outcome measured by completion of at least 75% of the telehealth sessions. Secondary outcomes included change in functional activity performance and neuropsychiatric behavioral symptoms. Results: Twenty-eight dyads participated. The intervention was feasible, with high adherence to weekly visits (M number of visits = 5.4 for HARMONY, 4.9 for standardized training, and 4.6 for control), with high participant retention in the intervention arms. HARMONY demonstrated promise in improving patient performance and behavioral symptoms. Conclusions and Relevance: HARMONY is feasibly delivered through telehealth service and has a positive effect on occupational performance and behavioral symptoms of AD. Additional studies are needed to explore effectiveness in a broader population. What This Article Adds: Use of HARMONY for community-residing adults with AD is feasible and has promise for improving functional activity performance and behavioral symptoms, as well as caregiver satisfaction.

Publisher

AOTA Press

Subject

Occupational Therapy

Link

https://research.aota.org/ajot/article-pdf/doi/10.5014/ajot.2023.050124/82639/7704205010.pdf

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