PMID- 31719067
OWN - NLM
STAT- MEDLINE
DCOM- 20201022
LR  - 20231019
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 9
IP  - 11
DP  - 2019 Nov 11
TI  - Occupational therapy for people with dementia and their family carers provided at 
      home: a systematic review and meta-analysis.
PG  - e026308
LID - 10.1136/bmjopen-2018-026308 [doi]
LID - e026308
AB  - OBJECTIVE: To determine the effect of occupational therapy provided at home on 
      activities of daily living, behavioural and psychological symptoms of dementia 
      (BPSD) and quality of life (QOL) for people with dementia, and the effect on 
      family carer burden, depression and QOL. DESIGN: Systematic review and 
      meta-analysis. METHODS: Eight databases were searched to February 2018. 
      Randomised controlled trials of occupational therapy delivered at home for people 
      with dementia and their family carers that measured ADL, and/or BPSD were 
      included. Two independent reviewers determined eligibility, risk of bias and 
      extracted data. RESULTS: Fifteen trials were included (n=2063). Occupational 
      therapy comprised multiple components (median=8 sessions). Compared with usual 
      care or attention control occupational therapy resulted in improvements in the 
      following outcomes for people with dementia: overall ADL after intervention 
      (standardised means difference (SMD) 0.61, 95% CI 0.16 to 1.05); instrumental ADL 
      alone (SMD 0.22, 95% CI 0.07 to 0.37; moderate quality); number of behavioural 
      and psychological symptoms (SMD -0.32, 95% CI -0.57 to -0.08; moderate quality); 
      and QOL (SMD 0.76, 95% CI 0.28 to 1.24) after the intervention and at follow-up 
      (SMD 1.07, 95% CI 0.58 to 1.55). Carers reported less hours assisting the person 
      with dementia (SMD -0.33, 95% CI -0.58 to -0.07); had less distress with 
      behaviours (SMD -0.23, 95% CI -0.42 to -0.05; moderate quality) and improved QOL 
      (SMD 0.99, 95% CI 0.66 to 1.33; moderate quality). Two studies compared 
      occupational therapy with a comparison intervention and found no statistically 
      significant results. GRADE ratings indicated evidence was very low to moderate 
      quality. CONCLUSIONS: Findings suggest that occupational therapy provided at home 
      may improve a range of important outcomes for people with dementia and their 
      family carers. Health professionals could consider referring them for 
      occupational therapy. PROSPERO REGISTRATION NUMBER: CRD42011001166.
CI  - (c) Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Bennett, Sally
AU  - Bennett S
AUID- ORCID: 0000-0002-4353-5027
AD  - School of Health and Rehabilitation Sciences, The University Queensland, 
      Brisbane, Queensland, Australia sally.bennett@uq.edu.au.
FAU - Laver, Kate
AU  - Laver K
AD  - Department of Rehabilitation, Aged and Extended Care, Flinders University, 
      Adelaide, South Australia, Australia.
FAU - Voigt-Radloff, Sebastian
AU  - Voigt-Radloff S
AD  - Institute for Evidence in Medicine (for Cochrane Germany Foundation), Center for 
      Geriatric Medicine and Gerontology, University of Freiburg, Germany.
FAU - Letts, Lori
AU  - Letts L
AD  - School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.
FAU - Clemson, Lindy
AU  - Clemson L
AD  - Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, 
      Australia.
FAU - Graff, Maud
AU  - Graff M
AD  - IQ Healthcare & Radboud Alzheimer Centre, Radboud University, Nijmegen, The 
      Netherlands.
FAU - Wiseman, Jodie
AU  - Wiseman J
AD  - Centre for Children's Health Research, The University of Queensland, Brisbane, 
      Queensland, Australia.
FAU - Gitlin, Laura
AU  - Gitlin L
AD  - College of Nursing and Health Professions, Drexel University, Philadelphia, 
      Pennsylvania, USA.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20191111
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - *Activities of Daily Living
MH  - Caregivers/*psychology
MH  - Dementia/*rehabilitation
MH  - Humans
MH  - Occupational Therapy/*methods
MH  - *Quality of Life
PMC - PMC6858232
OTO - NOTNLM
OT  - dementia
OT  - geriatric medicine
OT  - occupational therapy
OT  - systematic review
COIS- Competing interests: Four authors (MG, SV-R, LC and LG) are authors of trials 
      included in this systematic review. They were therefore not included in study 
      selection, assessment of risk of bias or analysis. LG reports funding grants from 
      National Institute on Aging, other from Johns Hopkins, during the conduct of the 
      study.
EDAT- 2019/11/14 06:00
MHDA- 2020/10/23 06:00
PMCR- 2019/11/11
CRDT- 2019/11/14 06:00
PHST- 2019/11/14 06:00 [entrez]
PHST- 2019/11/14 06:00 [pubmed]
PHST- 2020/10/23 06:00 [medline]
PHST- 2019/11/11 00:00 [pmc-release]
AID - bmjopen-2018-026308 [pii]
AID - 10.1136/bmjopen-2018-026308 [doi]
PST - epublish
SO  - BMJ Open. 2019 Nov 11;9(11):e026308. doi: 10.1136/bmjopen-2018-026308.