Contact information
Type
Scientific
Primary contact
Ms Karlijn Joling
ORCID ID
Contact details
Vrije University Medical Centre Amsterdam
EMGO-Institute
Department of General Practice
Amsterdam
1081 BT
Netherlands
+31 (0)20 444 8199/(444 1716 direct)
k.joling@vumc.nl
Additional identifiers
EudraCT number
ClinicalTrials.gov number
Protocol/serial number
N/A
Study information
Scientific title
Family Meetings in Memory clinics: indicated prevention of developing anxiety and depressive disorders in primary informal caregivers of demented patients
Acronym
FaMe
Study hypothesis
Affective disorders (i.e., depressive or anxiety disorders) of dementia caregivers are largely preventable.
Summary of Family Meetings in memory clinics (FaMe):
The growing group of family caregivers of dementia patients has a highly increased risk of developing depressive and anxiety disorders. An American landmark study reported substantial beneficial effects of family meetings on depression in family caregivers as well as on delay of institutionalisation of patients. These effects were not replicated in other countries yet. We perform the first trial comparing only structured family meetings with significant others versus usual care among primary family caregivers of community dwelling demented patients and measure the effectiveness on both depression and anxiety, both on disorder and symptom levels.
Four family meetings will be organised with the primary family caregiver of a community dwelling patient with a clinical diagnosis of dementia, family and close friends. Dyads of patients and their primary caregiver are followed up to two years after baseline assessment. The main outcome measure of the effect evaluation is the incidence of anxiety and depressive disorders assessed with the Mini-International Neuropsychiatric Interview (MINI) added with the time of onset in case of a disorder. The severity of anxiety and depressive symptoms is measured by validated self report instruments: the Centre for Epidemiologic Studies Depression Scale (CES-D) and Geriatric Depression Scale (GDS-5) for depression and the anxiety scales of the Hospital Anxiety and Depression scales (HADS) for anxiety. The economic evaluation is performed from a societal perspective.
Ethics approval
The Medical Ethics Committee of the VU University medical centre in Amsterdam has approved the study on July 18, 2007 (ref: 2007/83)
Study design
Multicentre, randomised, single-blinded, active controlled trial
Primary study design
Interventional
Secondary study design
Randomised controlled trial
Trial setting
Not specified
Trial type
Treatment
Patient information sheet
Not available in web format, please use the contact details below to request a patient information sheet
Condition
Affective disorders (i.e., depressive or anxiety disorders) of dementia caregivers
Intervention
Intervention group:
Primary caregivers of a community dwelling dementia patient and their family and close friends will receive four family meetings during a year. A trained counsellor will run the meetings according to a manual. The aim is to offer psycho-education, increase problem-solving skills and mobilise the naturally existing social network of patient by sharing support tasks of network members.
Usual care group:
Patients and their caregiver will receive the usual care given by the participating memory clinic.
Intervention type
Other
Phase
Not Specified
Drug names
Primary outcome measure
1. Incidence of major depression and anxiety disorders (i.e. generalised anxiety and panic) as defined according to DSM-IV criteria
2. Dimension/severity of anxiety and depression symptoms
Both primary and secondary outcome measures will be measured at baseline and at 6, 12, 18 and 24 months after baseline
Secondary outcome measures
Caregiver:
1. Caregiver Burden
2. Quality of life
Additional psychological questionnaires are used to explore profiles of caregivers who are best helped by the intervention.
Patients:
1. Depressive symptoms in patients (Neuropsychiatric Inventory [NPI])
2. Quality of life
Other:
1. (In)-direct costs caregiver and patient
2. Time until institutionalisation
Both primary and secondary outcome measures will be measured at baseline and at 6, 12, 18 and 24 months after baseline
Overall trial start date
01/09/2007
Overall trial end date
01/03/2012
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
1. Family caregiver who takes primary responsibility for the informal care of a community dwelling patient with a clinical diagnosis of dementia and who lives in the same region as the patient. We only include spouses, children (in-law), brothers and sisters of the patient
2. In each family, at least one other family member lives in the same region of the patient and caregiver
3. Both caregiver and patient have sufficient language proficiency in Dutch for adequate participation in meetings, interviews and tests
4. Written informed consent from both patient and caregiver is obtained. In case of mental incompetence of a patient the family caregiver will sign the consent for the patient
Participant type
Patient
Age group
Not Specified
Gender
Not Specified
Target number of participants
172
Participant exclusion criteria
1. Severe somatic or psychiatric co-morbidity of either caregiver or patient, which will significantly impair cooperation to the program
2. Either caregiver or patient participates in other intervention studies at inclusion or during the study
3. Scheduled to move a patient to a nursing home
Recruitment start date
01/09/2007
Recruitment end date
01/03/2012
Locations
Countries of recruitment
Netherlands
Trial participating centre
Vrije University Medical Centre Amsterdam
Amsterdam
1081 BT
Netherlands
Sponsor information
Organisation
Vrije University Medical Centre (VUMC) (The Netherlands)
Sponsor details
EMGO-Institute
Van der Boechorststraat 7
Amsterdam
1081 BT
Netherlands
+31 (0)20 444 8180
emgo@vumc.nl
Sponsor type
Hospital/treatment centre
Website
Funders
Funder type
Research organisation
Funder name
The Netherlands Organisation for Health Research and Development (ZonMw) (The Netherlands)
Alternative name(s)
Funding Body Type
Funding Body Subtype
Location
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Basic results (scientific)
Publication list
1. 2008 protocol in http://www.ncbi.nlm.nih.gov/pubmed/18208607
2. 2012 anxiety and depression results in http://www.ncbi.nlm.nih.gov/pubmed/22303473
3. 2012 time to nursing home results in http://www.ncbi.nlm.nih.gov/pubmed/22876304
4. 2013 cost-effectiveness results in: http://www.ncbi.nlm.nih.gov/pubmed/24053631
Publication citations
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Protocol
Joling KJ, van Hout HP, Scheltens P, Vernooij-Dassen M, van den Berg B, Bosmans J, Gillissen F, Mittelman M, van Marwijk HW, (Cost)-effectiveness of family meetings on indicated prevention of anxiety and depressive symptoms and disorders of primary family caregivers of patients with dementia: design of a randomized controlled trial., BMC Geriatr, 2008, 8, 2, doi: 10.1186/1471-2318-8-2.
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Anxiety and depression results
Joling KJ, van Marwijk HW, Smit F, van der Horst HE, Scheltens P, van de Ven PM, Mittelman MS, van Hout HP, Does a family meetings intervention prevent depression and anxiety in family caregivers of dementia patients? A randomized trial., PLoS ONE, 2012, 7, 1, e30936, doi: 10.1371/journal.pone.0030936.
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Time to nursing home results
Joling KJ, van Marwijk HW, van der Horst HE, Scheltens P, van de Ven PM, Appels BA, van Hout HP, Effectiveness of family meetings for family caregivers on delaying time to nursing home placement of dementia patients: a randomized trial., PLoS ONE, 2012, 7, 8, e42145, doi: 10.1371/journal.pone.0042145.
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Joling KJ, Bosmans JE, van Marwijk HW, van der Horst HE, Scheltens P, Vroomen JL, van Hout HP, The cost-effectiveness of a family meetings intervention to prevent depression and anxiety in family caregivers of patients with dementia: a randomized trial., Trials, 2013, 14, 305, doi: 10.1186/1745-6215-14-305.