Top

BMC Geriatrics

Published in:

Open Access 01-12-2024 | Research

Technology-based interventions on burden of older adults’ informal caregivers: a systematic review and meta-analysis of randomized controlled trials

Authors: Yang Zhou, Zhenggang Bai, Keyan Wan, Tianyi Qin, Rui He, Chengdan Xie

Published in: BMC Geriatrics | Issue 1/2024

Abstract

Background

An increasing number of technologies are provided to reduce the burden of older adults’ informal caregivers. However, less is known about the effects and the mechanism of technology to work on burden. This review is to evaluate the effectiveness of technology-based interventions (TBI) in alleviating the burden of older adults’ informal caregivers and to distinguish its effective mechanism via group disparities.

Methods

A systematic review and meta-analysis of randomized controlled trials studies (RCTs) has been conducted. Web of Science, PubMed, EMBASE, Scopus, CINAHL, PsycINFO, WANFANG, CNKI, CQVIP databases, Cochrane Library Trials, and ClinicalTrials.gov were searched for trial studies and registry in both English and Chinese published from January 1990 to October 2022. Reviewers independently screened the articles and trials, conducted quality assessments, and extracted the data. All processes were guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Risk of bias of the studies was evaluated by the Cochrane Systematic Review Handbook. The meta-analysis was conducted by RevMan 5.13. Subgroup analyses, sensitivity analyses, publication bias were also conducted.

Results

A total of 11,095 RCTs were initially screened, and 14 trials representing 1010 informal caregivers were included finally. This review proved TBI effective in reducing caregiving burden older adults. Subgroup analysis showed effects of TBI differed by interventions on control group and medical conditions of care recipients.

Conclusion

TBI is an effective way to alleviate the burden on informal caregivers of aging people. Interventions for control groups and medical conditions of care-recipients are significant factors in effective interventions. Future researches could include more trials with high-quality or to explore more targeted aging groups, modalities of TBI, or caregiver outcomes.

Trial registration

The review protocol was registered on PROSPERO [CRD42021277865].

Available only for authorised users

LeLaurin JH, Freytes IM, Findley KE, Schmitzberger MK, Eliazar-Macke ND, Orozco T, et al. Feasibility and acceptability of a telephone and web-based stroke caregiver intervention: a pilot randomized controlled trial of the RESCUE intervention. Clin Rehabil. 2021;35(2):253–5. https://doi.org/10.1177/0269215520957004.CrossRefPubMed

Czaja SJ, Loewenstein D, Schulz R, Nair SN, Perdomo D. A videophone psychosocial intervention for dementia caregivers. Am J Geriatr Psychiatry. 2013;21(11):1071–81. https://doi.org/10.1016/j.jagp.2013.02.019.CrossRefPubMed

Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontol. 1980;20(6):649–55. https://doi.org/10.1093/geront/20.6.649.CrossRef

Schulz R, O'Brien AT, Bookwala J, Fleissner K. Psychiatric and physical morbidity effects of dementia caregiving: prevalence, correlates, and causes. Gerontol. 1995;35(6):771–91. https://doi.org/10.1093/geront/35.6.771.CrossRef

Irani E, Niyomyart A, Hickman RL. Family caregivers' experiences and changes in caregiving tasks during the COVID-19 pandemic. Clin Nurs Res. 2021;30(7):1088–97. https://doi.org/10.1177/10547738211014211.CrossRefPubMedPubMedCentral

Piau A, Campo E, Rumeau P, Vellas B, Nourhashemi F. Aging society and gerontechnology: a solution for an independent living? J Nutr Health Aging. 2014;18(1):97–112. https://doi.org/10.1007/s12603-013-0356-5.CrossRefPubMed

Mahoney DM, Mutschler PH, Tarlow B, Liss E. Real world implementation lessons and outcomes from the worker interactive networking (WIN) project: workplace-based online caregiver support and remote monitoring of elders at home. Telemed J E Health. 2008;14(3):224–34. https://doi.org/10.1089/tmj.2007.0046.CrossRefPubMed

Lindeman DA, Kim KK, Gladstone C, Apesoa-Varano EC. Technology and caregiving: emerging interventions and directions for research. Gerontol. 2020;60(Suppl):41–9. https://doi.org/10.1093/geront/gnz178.CrossRef

Cristancho-Lacroix V, Wrobel J, Cantegreil-Kallen I, Dub T, Rouquette A, Rigaud AS. A web-based psychoeducational program for caregivers of patients with Alzheimer’s disease: a pilot randomized controlled trial. J Med Internet Res. 2015;17(5):e117. https://doi.org/10.2196/jmir.3717.CrossRefPubMedPubMedCentral

10.

De Stefano M, Esposito S, Iavarone A, Carpinelli Mazzi M, Siciliano M, Buonanno D, et al. Effects of phone-based psychological intervention on caregivers of patients with early-onset Alzheimer’s disease: a six-months study during the COVID-19 emergency in Italy. Brain Sci. 2022;12(3):310. https://doi.org/10.3390/brainsci12030310.CrossRefPubMedPubMedCentral

11.

Gustafson DH Jr, Gustafson DH, Cody OJ, Chih MY, Johnston DC, Asthana S. Pilot test of a computer-based system to help family caregivers of dementia patients. J Alzheimers Dis. 2019;70(2):541–52. https://doi.org/10.3233/JAD-190052.CrossRefPubMed

12.

Hattink B, Meiland F, Van der Roest H, Kevern P, Abiuso F, Bengtsson J, et al. Web-based STAR e-learning course increases empathy and understanding in dementia caregivers: results from a randomized controlled trial in the Netherlands and the United Kingdom. J Med Internet Res. 2015;17(10):e241. https://doi.org/10.2196/jmir.4025.CrossRefPubMedPubMedCentral

13.

Hayden LJ, Glynn SM, Hahn TJ, Randall F, Randolph E. The use of internet technology for psychoeducation and support with dementia caregivers. Psychol Serv. 2012;9(2):215–8. https://doi.org/10.1037/a0027056.CrossRefPubMed

14.

James TA, James D, Larkey LK. Heart-focused breathing and perceptions of burden in Alzheimer's caregivers: an online randomized controlled pilot study. Geriatr Nurs. 2012;42(2):397–404. https://doi.org/10.1016/j.gerinurse.2021.02.006.CrossRef

15.

Kales HC, Gitlin LN, Stanislawski B, Kim HM, Marx K, Turnwald M, et al. Effect of the WeCareAdvisor (TM) on family caregiver outcomes in dementia: a pilot randomized controlled trial. BMC Geriatr. 2018;18(1):113. https://doi.org/10.1186/s12877-018-0801-8.CrossRefPubMedPubMedCentral

16.

Meichsner F, Theurer C, Wilz G. Acceptance and treatment effects of an internet-delivered cognitive-behavioral intervention for family caregivers of people with dementia: a randomized-controlled trial. J Clin Psychol. 2019;75(4):594–613. https://doi.org/10.1002/jclp.22739.CrossRefPubMed

17.

Meiland F, Innes A, Mountain G, Robinson L, Van der Roest H, Garcia-Casal JA, et al. Technologies to support community-dwelling persons with dementia: a position paper on issues regarding development, usability, effectiveness and cost-effectiveness, deployment, and ethics. JMIR Rehabil Assist Technol. 2017;4(1):e1. https://doi.org/10.2196/rehab.6376.CrossRefPubMedPubMedCentral

18.

Metcalfe A, Jones B, Mayer J, Gage H, Oyebode J, Boucault S, et al. Online information and support for carers of people with young-onset dementia: a multi-site randomised controlled pilot study. Int J Geriatr Psychiatry. 2019;34(10):1455–64. https://doi.org/10.1002/gps.5154.CrossRefPubMed

19.

Torkamani M, McDonald L, Aguayo IS, Kanios C, Katsanou MN, Madeley L, et al. A randomized controlled pilot study to evaluate a technology platform for the assisted living of people with dementia and their carers. J Alzheimers Dis. 2014;41(2):515–23. https://doi.org/10.3233/JAD-132156.CrossRefPubMed

20.

Wilz G, Reder M, Meichsner F, Soellner R. The Tele.TAnDem intervention: telephone-based CBT for family caregivers of people with dementia. Gerontol. 2018;58(2):118–29. https://doi.org/10.1093/geront/gnx183.CrossRef

21.

Mo GY, Biss RK, Poole L, Stern B, Waite K, Murphy KJ. Technology use among family caregivers of people with dementia. Can J Aging. 2021;40(2):331–43. https://doi.org/10.1017/S0714980820000094.CrossRefPubMed

22.

Biliunaite I, Kazlauskas E, Sanderman R, Truskauskaite-Kuneviciene I, Dumarkaite A, Andersson G. Internet-based cognitive behavioral therapy for informal caregivers: randomized controlled pilot trial. J Med Internet Res. 2021;23(4):e21466. https://doi.org/10.2196/21466.CrossRefPubMedPubMedCentral

23.

Lorca-Cabrera J, Grau C, Marti-Arques R, Raigal-Aran L, Falco-Pegueroles A, Albacar-Rioboo N. Effectiveness of health web-based and mobile app-based interventions designed to improve informal caregiver's well-being and quality of life: a systematic review. Int J Med Inform. 2020;134:104003. https://doi.org/10.1016/j.ijmedinf.2019.104003.CrossRefPubMed

24.

Myhre JW, Mehl MR, Glisky EL. Cognitive benefits of online social networking for healthy older adults. J Gerontol B Psychol Sci Soc Sci. 2017;72(5):752–60. https://doi.org/10.1093/geronb/gbw025.CrossRefPubMed

25.

Ploeg J, Markle-Reid M, Valaitis R, McAiney C, Duggleby W, Bartholomew A, et al. Web-based interventions to improve mental health, general caregiving outcomes, and general health for caregivers of adults with chronic conditions living in the community: rapid evidence review. J Med Internet Res. 2017;19(7):e263. https://doi.org/10.2196/jmir.7564.CrossRefPubMedPubMedCentral

26.

Mitzner TL, Stuck R, Hartley JQ, Beer JM, Rogers WA. Acceptance of televideo technology by adults aging with a mobility impairment for health and wellness interventions. J Rehabil Assist Technol Eng. 2017;4:2055668317692755. https://doi.org/10.1177/2055668317692755.CrossRefPubMedPubMedCentral

27.

Cotten SR. Examining the roles of technology in aging and ouality of life [editorial material]. J Gerontol B Psychol Sci Soc Sci. 2017;72(5):823–6. https://doi.org/10.1093/geronb/gbx109.CrossRefPubMed

28.

Godwin KM, Mills WL, Anderson JA, Kunik ME. Technology-driven interventions for caregivers of persons with dementia: a systematic review [review]. Am J Alzheimers Dis Other Dement. 2013;28(3):216–22. https://doi.org/10.1177/1533317513481091.CrossRef

29.

Ruggiano N, Brown EL, Shaw S, Geldmacher D, Clarke P, Hristidis V, et al. The potential of information technology to navigate caregiving systems: perspectives from dementia caregivers. J Gerontol Soc Work. 2019;62(4):432–50. https://doi.org/10.1080/01634372.2018.1546786.CrossRefPubMed

30.

Schulz R, Wahl HW, Matthews JT, De Vito DA, Beach SR, Czaja SJ. Advancing the aging and technology agenda in gerontology. Gerontol. 2015;55(5):724–34. https://doi.org/10.1093/geront/gnu071.CrossRef

31.

Ferre-Grau C, Raigal-Aran L, Lorca-Cabrera J, Lluch-Canut T, Ferre-Bergada M, Leixa-Fortuno M, et al. A mobile app-based intervention program for nonprofessional caregivers to promote positive mental health: randomized controlled trial. JMIR Mhealth Uhealth. 2021;9(1):18. https://doi.org/10.2196/21708.CrossRef

32.

Mortenson WB, Demers L, Fuhrer MJ, Jutai JW, Bilkey J, Plante M, et al. Effects of a caregiver-inclusive assistive technology intervention: a randomized controlled trial. BMC Geriatr. 2018;18(1):1–12. https://doi.org/10.1186/s12877-018-0783-6.CrossRef

33.

Czaja SJ, Charness N, Fisk AD, Hertzog C, Nair SN, Rogers WA, et al. Factors predicting the use of technology: findings from the Center for Research and Education on aging and technology enhancement (CREATE). Psychol Aging. 2006;21(2):333–52. https://doi.org/10.1037/0882-7974.21.2.333.CrossRefPubMedPubMedCentral

34.

Højlund H, Villadsen K. Technologies in caregiving: professionals’ strategies for engaging with new technology. New Technol Work Employ. 2020;35(2):178–94. https://doi.org/10.1111/ntwe.12161.CrossRef

35.

Chin WJ, Ho YLS, Ramazanu S, Itoh S, Klainin-Yobas P, Wu XV. Effectiveness of technology-based interventions on psychological morbidities, quality of life for informal caregivers of stroke survivors: a systematic review and meta-analysis. J Adv Nurs. 2022;78(4):947–67. https://doi.org/10.1111/jan.15130.CrossRefPubMed

36.

Hopwood J, Walker N, McDonagh L, Rait G, Walters K, Iliffe S, et al. Internet-based interventions aimed at supporting family caregivers of people with dementia: systematic review. J Med Internet Res. 2018;20(6):12. https://doi.org/10.2196/jmir.9548.CrossRef

37.

Etxeberria I, Salaberria K, Gorostiaga A. Online support for family caregivers of people with dementia: a systematic review and meta-analysis of RCTs and quasi-experimental studies. Aging Ment Health. 2021;25(7):1165–80. https://doi.org/10.1080/13607863.2020.1758900.CrossRefPubMed

38.

Marasinghe KM. Assistive technologies in reducing caregiver burden among caregivers of older adults: a systematic review. Disabil Rehabil Assist Technol. 2016;11(5):353–60. https://doi.org/10.3109/17483107.2015.1087061.CrossRef

39.

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. PLoS Med. 2021;18(3):e1003583. https://doi.org/10.1371/journal.pmed.1003583.CrossRefPubMedPubMedCentral

40.

Higgins JPT, Altman DG, Gotzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:9. https://doi.org/10.1136/bmj.d5928.CrossRef

41.

Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction—GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64(4):383–94. https://doi.org/10.1016/j.jclinepi.2010.04.026.CrossRefPubMed

42.

Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analysis. BMJ. 2013;327(7414):557–60. https://doi.org/10.1136/bmj.327.7414.557.CrossRef

43.

Levenson RW. In-Home Technology for Caregivers of People With Dementia and Mild Cognitive Impairment. ClinicalTrials.gov.https://clinicaltrials.gov/ct2/show/results/NCT04206670. Accessed 14 Nov 2022.

44.

Scott JL, Dawkins S, Quinn MG, Sanderson K, Elliott KEJ, Stirling C. Caring for the carer: a systematic review of pure technology-based cognitive behavioral therapy (TB-CBT) interventions for dementia carers. Aging Ment Health. 2016;20(8):793–803. https://doi.org/10.1080/13607863.2015.1040724.CrossRefPubMed

Title: Technology-based interventions on burden of older adults’ informal caregivers: a systematic review and meta-analysis of randomized controlled trials
Authors: Yang Zhou
Zhenggang Bai
Keyan Wan
Tianyi Qin
Rui He
Chengdan Xie
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: BMC Geriatrics / Issue 1/2024
Electronic ISSN: 1471-2318
DOI: https://doi.org/10.1186/s12877-024-05018-w

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Trial registration

Please log in to get access to this content

Other articles of this Issue 1/2024

Association between diet quality and malnutrition: pooled results from two population-based studies in older adults

Risk factors for falls in older adults with diabetes mellitus: systematic review and meta-analysis

Development of the assessment standards of the International Classification of Functioning, Disability, and Health (ICF) Geriatric Core Set through a modified Delphi method

The prevalence and impact of sarcopenia in older cardiac patients undergoing inpatient cardiac rehabilitation – results from a prospective, observational cohort pre-study

Primary caregivers’ experiences of caring for people living with dementia in Ghana: a phenomenological study

Process evaluation of a tailored nudge intervention to promote appropriate care and treatment of older patients at the end-of-life

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials