Skip to main content
Top
Published in: Trials 1/2023

Open Access 01-12-2023 | Amyotrophic Lateral Sclerosis | Study protocol

Digital peer-to-peer support programme for informal caregivers of people living with motor neuron disease: study protocol for a multi-centre parallel group, single-blinded (outcome assessor) randomised controlled superiority trial

Authors: Louise Rose, Thilipan Thaventhiran, Esther Hobson, Rebecca Rogers, Kirsty James, Petrina Chu, Ben Carter, Christina Faull, Sian Saha, Jeong Su Lee, Georgios Kaltsakas, Christopher McDermott, Michelle Ramsay

Published in: Trials | Issue 1/2023

Login to get access

Abstract

Background

Peer support is effective in improving psychological well-being of family caregivers of people with conditions such as dementia, cancer, and brain injury. However, there are limited data on effective psychological interventions for family caregivers of people living with motor neurone disease. Our objective is to evaluate the efficacy of a virtual peer support programme for improving caregiver psychological wellbeing and caregiving related outcomes.

Methods

We will conduct a multi-centre parallel group randomised controlled superiority trial. Using a multi-modal recruitment strategy, we will recruit informal caregivers from UK MND clinics, in-patient units, and hospices. We will randomise (1:1, stratified by gender) participants to either a 12-week virtual peer support programme or usual care comprising provision of online information resources publicly available via the MND Association website. Peer support programme elements will be delivered via a secure digital e-platform aTouchAway™ (Aetonix, Canada). Our target sample size is 160 (80 each arm). Our primary outcome is the Hospital Anxiety and Depression Scale (HADS) assessed at 12 weeks (primary endpoint). Secondary outcomes that will also be assessed at 12 weeks include the Zarit Burden Interview, Pearlin Mastery Scale, Personal Gain Scale, Positive Affect Scale, and the Brief COPE. Outcome assessors will be blinded to allocation. Tertiary outcomes include perceived usability (1 item 9-point Likert scale) and acceptability (semi-structured qualitative interviews) of the peer support programme. Intervention fidelity measures will comprise frequency, type (text, audio, video), and duration (audio and video) of peer support contact downloaded from the aTouchAway AWS server. We will use a mixed-effects linear model to test the effect of the intervention on the primary outcome. Secondary outcomes will be analysed using linear regression. We have ethical approval (21/NW/0269) from the North-West Research Ethics Committee, UK.

Discussion

This single-blinded randomised controlled trial will determine the effect of a virtual peer support programme on caregiver psychological wellbeing and caregiver burden. This study will examine the impact of a virtual peer support intervention on quality-of-life measures in informal caregivers of individuals with MND living in the community.

Trial registration

ClinicalTrials.gov: NCT04695210
Literature
1.
go back to reference Peters M, Rand S, Fitzpatrick R. Enhancing primary care support for informal carers: a scoping study with professional stakeholders. Health Soc Care Community. 2020;28(2):642–50.CrossRefPubMed Peters M, Rand S, Fitzpatrick R. Enhancing primary care support for informal carers: a scoping study with professional stakeholders. Health Soc Care Community. 2020;28(2):642–50.CrossRefPubMed
2.
go back to reference Vlachantoni A, Feng Z, Wang N, Evandrou M. Social participation and health outcomes among caregivers and noncaregivers in Great Britain. J Appl Gerontol. 2020;39(12):1313–22.CrossRefPubMed Vlachantoni A, Feng Z, Wang N, Evandrou M. Social participation and health outcomes among caregivers and noncaregivers in Great Britain. J Appl Gerontol. 2020;39(12):1313–22.CrossRefPubMed
3.
go back to reference Knibb JA, Keren N, Kulka A, Leigh PN, Martin S, Shaw CE, Tsuda M, Al-Chalabi A. A clinical tool for predicting survival in ALS. J Neurol Neurosurg Psychiatry. 2016;87(12):1361–7.CrossRefPubMed Knibb JA, Keren N, Kulka A, Leigh PN, Martin S, Shaw CE, Tsuda M, Al-Chalabi A. A clinical tool for predicting survival in ALS. J Neurol Neurosurg Psychiatry. 2016;87(12):1361–7.CrossRefPubMed
4.
go back to reference Goldstein LH, Atkins L, Landau S, Brown R, Leigh PN. Predictors of psychological distress in carers of people with amyotrophic lateral sclerosis: a longitudinal study. Psychol Med. 2006;36(6):865–75.CrossRefPubMed Goldstein LH, Atkins L, Landau S, Brown R, Leigh PN. Predictors of psychological distress in carers of people with amyotrophic lateral sclerosis: a longitudinal study. Psychol Med. 2006;36(6):865–75.CrossRefPubMed
5.
go back to reference Gauthier A, Vignola A, Calvo A, Cavallo E, Moglia C, Sellitti L, Mutani R, Chio A. A longitudinal study on quality of life and depression in ALS patient-caregiver couples. Neurology. 2007;68(12):923–6.CrossRefPubMed Gauthier A, Vignola A, Calvo A, Cavallo E, Moglia C, Sellitti L, Mutani R, Chio A. A longitudinal study on quality of life and depression in ALS patient-caregiver couples. Neurology. 2007;68(12):923–6.CrossRefPubMed
6.
go back to reference Bergin S, Mockford C. Recommendations to support informal carers of people living with motor neurone disease. Br J Community Nurs. 2016;21(10):518–24.CrossRefPubMed Bergin S, Mockford C. Recommendations to support informal carers of people living with motor neurone disease. Br J Community Nurs. 2016;21(10):518–24.CrossRefPubMed
7.
go back to reference Creemers H, Veldink JH, Grupstra H, Nollet F, Beelen A, van den Berg LH. Cluster RCT of case management on patients’ quality of life and caregiver strain in ALS. Neurology. 2014;82(1):23–31.CrossRefPubMed Creemers H, Veldink JH, Grupstra H, Nollet F, Beelen A, van den Berg LH. Cluster RCT of case management on patients’ quality of life and caregiver strain in ALS. Neurology. 2014;82(1):23–31.CrossRefPubMed
8.
go back to reference van Groenestijn AC, Schroder CD, Visser-Meily JM, Reenen ET, Veldink JH, van den Berg LH. Cognitive behavioural therapy and quality of life in psychologically distressed patients with amyotrophic lateral sclerosis and their caregivers: results of a prematurely stopped randomized controlled trial. Amyotroph Lateral Scler Frontotemporal Degener. 2015;16(5–6):309–15.CrossRefPubMed van Groenestijn AC, Schroder CD, Visser-Meily JM, Reenen ET, Veldink JH, van den Berg LH. Cognitive behavioural therapy and quality of life in psychologically distressed patients with amyotrophic lateral sclerosis and their caregivers: results of a prematurely stopped randomized controlled trial. Amyotroph Lateral Scler Frontotemporal Degener. 2015;16(5–6):309–15.CrossRefPubMed
9.
go back to reference O’Connor MF, Arizmendi BJ, Kaszniak AW. Virtually supportive: a feasibility pilot study of an online support group for dementia caregivers in a 3D virtual environment. J Aging Stud. 2014;30:87–93.CrossRefPubMedPubMedCentral O’Connor MF, Arizmendi BJ, Kaszniak AW. Virtually supportive: a feasibility pilot study of an online support group for dementia caregivers in a 3D virtual environment. J Aging Stud. 2014;30:87–93.CrossRefPubMedPubMedCentral
10.
go back to reference O’Brien MR, Whitehead B, Jack BA, Mitchell JD. The need for support services for family carers of people with motor neurone disease (MND): views of current and former family caregivers a qualitative study. Disabil Rehabil. 2012;34(3):247–56.CrossRefPubMed O’Brien MR, Whitehead B, Jack BA, Mitchell JD. The need for support services for family carers of people with motor neurone disease (MND): views of current and former family caregivers a qualitative study. Disabil Rehabil. 2012;34(3):247–56.CrossRefPubMed
11.
go back to reference Feeney BC, Collins NL. A new look at social support: a theoretical perspective on thriving through relationships. Pers Soc Psychol Rev. 2015;19(2):113–47.CrossRefPubMed Feeney BC, Collins NL. A new look at social support: a theoretical perspective on thriving through relationships. Pers Soc Psychol Rev. 2015;19(2):113–47.CrossRefPubMed
12.
go back to reference Sabir M, Pillemer K, Suitor J, Patterson M. Predictors of successful relationships in a peer support program for Alzheimer’s caregivers. Am J Alzheimers Dis Other Demen. 2003;18(2):115–22.CrossRefPubMed Sabir M, Pillemer K, Suitor J, Patterson M. Predictors of successful relationships in a peer support program for Alzheimer’s caregivers. Am J Alzheimers Dis Other Demen. 2003;18(2):115–22.CrossRefPubMed
13.
go back to reference Hibbard MR, Cantor J, Charatz H, Rosenthal R, Ashman T, Gundersen N, Ireland-Knight L, Gordon W, Avner J, Gartner A. Peer support in the community: initial findings of a mentoring program for individuals with traumatic brain injury and their families. J Head Trauma Rehabil. 2002;17(2):112–31.CrossRefPubMed Hibbard MR, Cantor J, Charatz H, Rosenthal R, Ashman T, Gundersen N, Ireland-Knight L, Gordon W, Avner J, Gartner A. Peer support in the community: initial findings of a mentoring program for individuals with traumatic brain injury and their families. J Head Trauma Rehabil. 2002;17(2):112–31.CrossRefPubMed
14.
go back to reference Cohen S, Wills TA. Stress, social support, and the buffering hypothesis. Psychol Bull. 1985;98(2):310–57.CrossRefPubMed Cohen S, Wills TA. Stress, social support, and the buffering hypothesis. Psychol Bull. 1985;98(2):310–57.CrossRefPubMed
15.
go back to reference Pinquart M, Sorensen S. Correlates of physical health of informal caregivers: a meta-analysis. J Gerontol B Psychol Sci Soc Sci. 2007;62(2):P126-137.CrossRefPubMed Pinquart M, Sorensen S. Correlates of physical health of informal caregivers: a meta-analysis. J Gerontol B Psychol Sci Soc Sci. 2007;62(2):P126-137.CrossRefPubMed
16.
go back to reference Wasilewski MB, Stinson JN, Cameron JI. Web-based health interventions for family caregivers of elderly individuals: A Scoping Review. Int J Med Inform. 2017;103:109–38.CrossRefPubMed Wasilewski MB, Stinson JN, Cameron JI. Web-based health interventions for family caregivers of elderly individuals: A Scoping Review. Int J Med Inform. 2017;103:109–38.CrossRefPubMed
17.
go back to reference Baxter SK, Baird WO, Thompson S, Bianchi SM, Walters SJ, Lee E, Ahmedzai SH, Proctor A, Shaw PJ, McDermott CJ. The impact on the family carer of motor neurone disease and intervention with noninvasive ventilation. J Palliat Med. 2013;16(12):1602–9.CrossRefPubMedPubMedCentral Baxter SK, Baird WO, Thompson S, Bianchi SM, Walters SJ, Lee E, Ahmedzai SH, Proctor A, Shaw PJ, McDermott CJ. The impact on the family carer of motor neurone disease and intervention with noninvasive ventilation. J Palliat Med. 2013;16(12):1602–9.CrossRefPubMedPubMedCentral
18.
go back to reference Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70.CrossRefPubMed Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70.CrossRefPubMed
19.
go back to reference Kudra A, Lees C, Morrell-Scott N. Measuring carer burden in informal carers of patients with long-term conditions. Br J Community Nurs. 2017;22(5):230–6.CrossRefPubMed Kudra A, Lees C, Morrell-Scott N. Measuring carer burden in informal carers of patients with long-term conditions. Br J Community Nurs. 2017;22(5):230–6.CrossRefPubMed
20.
go back to reference Conroy E, Kennedy P, Heverin M, Leroi I, Mayberry E, Beelen A, Stavroulakis T, van den Berg LH, McDermott CJ, Hardiman O et al: Informal caregivers in amyotrophic lateral sclerosis: a multi-centre, exploratory study of burden and difficulties. Brain Sci 2021, 11(8):1094. Conroy E, Kennedy P, Heverin M, Leroi I, Mayberry E, Beelen A, Stavroulakis T, van den Berg LH, McDermott CJ, Hardiman O et al: Informal caregivers in amyotrophic lateral sclerosis: a multi-centre, exploratory study of burden and difficulties. Brain Sci 2021, 11(8):1094.
21.
go back to reference Sherifali D, Ali MU, Ploeg J, Markle-Reid M, Valaitis R, Bartholomew A, Fitzpatrick-Lewis D, McAiney C. Impact of Internet-based interventions on caregiver mental health: systematic review and meta-analysis. J Med Internet Res. 2018;20(7): e10668.CrossRefPubMedPubMedCentral Sherifali D, Ali MU, Ploeg J, Markle-Reid M, Valaitis R, Bartholomew A, Fitzpatrick-Lewis D, McAiney C. Impact of Internet-based interventions on caregiver mental health: systematic review and meta-analysis. J Med Internet Res. 2018;20(7): e10668.CrossRefPubMedPubMedCentral
22.
go back to reference de Wit J, Beelen A, Drossaert CHC, Kolijn R, van den Berg LH, Visser-Meily JMA, Schroder CD. A blended psychosocial support program for partners of patients with amyotrophic lateral sclerosis and progressive muscular atrophy: protocol of a randomized controlled trial. BMC Psychol. 2018;6(1):20.CrossRefPubMedPubMedCentral de Wit J, Beelen A, Drossaert CHC, Kolijn R, van den Berg LH, Visser-Meily JMA, Schroder CD. A blended psychosocial support program for partners of patients with amyotrophic lateral sclerosis and progressive muscular atrophy: protocol of a randomized controlled trial. BMC Psychol. 2018;6(1):20.CrossRefPubMedPubMedCentral
23.
go back to reference Bjelland I, Dahl AA, Haug TT, Neckelmann D: The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 2002, 52(2):69–77. Bjelland I, Dahl AA, Haug TT, Neckelmann D: The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 2002, 52(2):69–77.
24.
go back to reference Pearlin LI, Mullan JT, Semple SJ, Skaff MM. Caregiving and the stress process: an overview of concepts and their measures. Gerontologist. 1990;30(5):583–94.CrossRefPubMed Pearlin LI, Mullan JT, Semple SJ, Skaff MM. Caregiving and the stress process: an overview of concepts and their measures. Gerontologist. 1990;30(5):583–94.CrossRefPubMed
25.
go back to reference Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist. 1980;20(6):649–55.CrossRefPubMed Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist. 1980;20(6):649–55.CrossRefPubMed
26.
go back to reference Schreiner AS, Morimoto T, Arai Y, Zarit S. Assessing family caregiver’s mental health using a statistically derived cut-off score for the Zarit Burden Interview. Aging Ment Health. 2006;10(2):107–11.CrossRefPubMed Schreiner AS, Morimoto T, Arai Y, Zarit S. Assessing family caregiver’s mental health using a statistically derived cut-off score for the Zarit Burden Interview. Aging Ment Health. 2006;10(2):107–11.CrossRefPubMed
27.
go back to reference Burke T, Elamin M, Galvin M, Hardiman O, Pender N. Caregiver burden in amyotrophic lateral sclerosis: a cross-sectional investigation of predictors. J Neurol. 2015;262(6):1526–32.CrossRefPubMed Burke T, Elamin M, Galvin M, Hardiman O, Pender N. Caregiver burden in amyotrophic lateral sclerosis: a cross-sectional investigation of predictors. J Neurol. 2015;262(6):1526–32.CrossRefPubMed
28.
go back to reference Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988;54(6):1063–70.CrossRefPubMed Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988;54(6):1063–70.CrossRefPubMed
29.
30.
go back to reference Pudrovska T, Schieman S, Pearlin LI, Nguyen K. The sense of mastery as a mediator and moderator in the association between economic hardship and health in late life. J Aging Health. 2005;17(5):634–60.CrossRefPubMed Pudrovska T, Schieman S, Pearlin LI, Nguyen K. The sense of mastery as a mediator and moderator in the association between economic hardship and health in late life. J Aging Health. 2005;17(5):634–60.CrossRefPubMed
31.
go back to reference Carver CS. You want to measure coping but your protocol’s too long: consider the brief COPE. Int J Behav Med. 1997;4(1):92–100.CrossRefPubMed Carver CS. You want to measure coping but your protocol’s too long: consider the brief COPE. Int J Behav Med. 1997;4(1):92–100.CrossRefPubMed
32.
go back to reference Cameron JI, Franche RL, Cheung AM, Stewart DE. Lifestyle interference and emotional distress in family caregivers of advanced cancer patients. Cancer. 2002;94(2):521–7.CrossRefPubMed Cameron JI, Franche RL, Cheung AM, Stewart DE. Lifestyle interference and emotional distress in family caregivers of advanced cancer patients. Cancer. 2002;94(2):521–7.CrossRefPubMed
33.
go back to reference Cameron JI, Cheung AM, Streiner DL, Coyte PC, Stewart DE. Stroke survivors’ behavioral and psychologic symptoms are associated with informal caregivers’ experiences of depression. Arch Phys Med Rehabil. 2006;87(2):177–83.CrossRefPubMed Cameron JI, Cheung AM, Streiner DL, Coyte PC, Stewart DE. Stroke survivors’ behavioral and psychologic symptoms are associated with informal caregivers’ experiences of depression. Arch Phys Med Rehabil. 2006;87(2):177–83.CrossRefPubMed
35.
go back to reference Sekhon M, Cartwright M, Francis JJ. Acceptability of health care interventions: a theoretical framework and proposed research agenda. Br J Health Psychol. 2018;23(3):519–31.CrossRefPubMed Sekhon M, Cartwright M, Francis JJ. Acceptability of health care interventions: a theoretical framework and proposed research agenda. Br J Health Psychol. 2018;23(3):519–31.CrossRefPubMed
36.
go back to reference Sekhon M, Cartwright M, Francis JJ. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Serv Res. 2017;17(1):88.CrossRefPubMedPubMedCentral Sekhon M, Cartwright M, Francis JJ. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Serv Res. 2017;17(1):88.CrossRefPubMedPubMedCentral
37.
go back to reference Francis JJ, Johnston M, Robertson C, Glidewell L, Entwistle V, Eccles MP, Grimshaw JM. What is an adequate sample size? Operationalising data saturation for theory-based interview studies. Psychol Health. 2010;25(10):1229–45.CrossRefPubMed Francis JJ, Johnston M, Robertson C, Glidewell L, Entwistle V, Eccles MP, Grimshaw JM. What is an adequate sample size? Operationalising data saturation for theory-based interview studies. Psychol Health. 2010;25(10):1229–45.CrossRefPubMed
38.
go back to reference Bengtsson M. How to plan and perform a qualitative study using content analysis. NursingPlus Open. 2016;2:8–14.CrossRef Bengtsson M. How to plan and perform a qualitative study using content analysis. NursingPlus Open. 2016;2:8–14.CrossRef
39.
go back to reference Montgomery P, Grant S, Mayo-Wilson E, Macdonald G, Michie S, Hopewell S, Moher D, Group C-S. Reporting randomised trials of social and psychological interventions: the CONSORT-SPI 2018 Extension. Trials. 2018;19(1):407.CrossRef Montgomery P, Grant S, Mayo-Wilson E, Macdonald G, Michie S, Hopewell S, Moher D, Group C-S. Reporting randomised trials of social and psychological interventions: the CONSORT-SPI 2018 Extension. Trials. 2018;19(1):407.CrossRef
Metadata
Title
Digital peer-to-peer support programme for informal caregivers of people living with motor neuron disease: study protocol for a multi-centre parallel group, single-blinded (outcome assessor) randomised controlled superiority trial
Authors
Louise Rose
Thilipan Thaventhiran
Esther Hobson
Rebecca Rogers
Kirsty James
Petrina Chu
Ben Carter
Christina Faull
Sian Saha
Jeong Su Lee
Georgios Kaltsakas
Christopher McDermott
Michelle Ramsay
Publication date
01-12-2023
Publisher
BioMed Central
Published in
Trials / Issue 1/2023
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-023-07124-3

Other articles of this Issue 1/2023

Trials 1/2023 Go to the issue