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Open Access 01-12-2018 | Research article

Translating evidence to patient care through caregivers: a systematic review of caregiver-mediated interventions

Authors: Kirsten M. Fiest, Christiane Job McIntosh, Danielle Demiantschuk, Jeanna Parsons Leigh, Henry T. Stelfox

Published in: BMC Medicine | Issue 1/2018

Abstract

Background

Caregivers may promote the uptake of science into patient care and the practice of evidence-informed medicine. The purpose of this study was to determine whether caregiver-mediated (non-clinical caregiver-delivered) interventions are effective in improving patient, caregiver, provider, or health system outcomes.

Methods

We searched the MEDLINE, Embase, PsycINFO, Cumulative Index of Nursing and Allied Health, and Scopus databases from inception to February 27, 2017. Interventions (with a comparison group) reporting on a quality improvement intervention mediated by a caregiver and directed to a patient, in all ages and patient-care settings, were selected for inclusion. A three-category framework was developed to characterize caregiver-mediated interventions: inform (e.g., provide knowledge), activate (e.g., prompt action), and collaborate (e.g., lead to interaction between caregivers and other groups [e.g., care providers]).

Results

Fifty-six studies met the inclusion criteria, and 64% were randomized controlled trials (RCTs). The most commonly assessed outcomes were patient- (n = 40) and caregiver-oriented (n = 33); few health system- (n = 10) and provider-oriented (n = 2) outcomes were reported. Patient outcomes (e.g., satisfaction) were most improved by caregiver-mediated interventions that provided condition and treatment education (e.g., symptom management information) and practical condition-management support (e.g., practicing medication protocol). Caregiver outcomes (e.g., stress-related/psychiatric outcomes) were most improved by interventions that activated caregiver roles (e.g., monitoring blood glucose) and provided information related to that action (e.g., why and how to monitor). The risk of bias was generally high, and the overall quality of the evidence was low-moderate, based on Grading of Recommendations Assessment Development and Evaluation ratings.

Conclusions

There is a large body of research, including many RCTs, to support the use of caregiver-mediated interventions that inform and activate caregivers to improve patient and caregiver outcomes. Select caregiver-mediated interventions improve patient (inform-activate) and caregiver (inform-activate-collaborate) outcomes and should be considered by all researchers implementing patient- and family-oriented research.

Systematic review

PROSPERO, CRD42016052509.

Available only for authorised users

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Title: Translating evidence to patient care through caregivers: a systematic review of caregiver-mediated interventions
Authors: Kirsten M. Fiest
Christiane Job McIntosh
Danielle Demiantschuk
Jeanna Parsons Leigh
Henry T. Stelfox
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Medicine / Issue 1/2018
Electronic ISSN: 1741-7015
DOI: https://doi.org/10.1186/s12916-018-1097-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Translating evidence to patient care through caregivers: a systematic review of caregiver-mediated interventions

Abstract

Background

Methods

Results

Conclusions

Systematic review

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Systematic review

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