TY - JOUR A1 - Deeken, Friederike A1 - Rezo, Anna A1 - Hinz, Matthias A1 - Discher, Robert A1 - Rapp, Michael Armin T1 - Evaluation of technology-based interventions for informal caregivers of patients with dementia BT - a Meta-Analysis of Randomized Controlled Trials JF - The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry N2 - Objective: The aim of this study was to estimate the efficacy of technology-based interventions for informal caregivers of people with dementia (PWD). Methods: PubMed, PsycINFO, and Cochrane Library databases were searched in August 2018, with no restrictions in language or publication date. Two independent reviewers identified 33 eligible randomized controlled trials (RCTs) conducting a technology-based intervention for informal carers of PWD. Meta-analyses for the outcome measures caregiver depression and caregiver burden were conducted with subgroup analyses according to mode of delivery (telephone, computer/web-based, combined interventions). To assess methodologic quality, the Cochrane risk-of-bias assessment was rated. Results: Meta-analyses revealed a small but significant postintervention effect of technology-based interventions for caregiver depression and caregiver burden. Combined interventions showed the strongest effects. Conclusion: Technology-based interventions have the potential to support informal caregivers of PWD. Because of advantages such as high flexibility and availability, technology-based interventions provide a promising alternative compared with "traditional services," e.g., those for people living in rural areas. More high-quality RCTs for specific caregiver groups are needed. KW - Caregiver KW - dementia KW - technology KW - meta-analysis Y1 - 2019 U6 - https://doi.org/10.1016/j.jagp.2018.12.003 SN - 1064-7481 SN - 1545-7214 VL - 27 IS - 4 SP - 426 EP - 445 PB - Elsevier CY - New York ER - TY - JOUR A1 - Sánchez, Alba A1 - Thomas, Christine A1 - Deeken, Friederike A1 - Wagner, Sören A1 - Klöppel, Stefan A1 - Kentischer, Felix A1 - von Arnim, Chrstine A. F. A1 - Denkinger, Michael A1 - Conzelmann, Lars O. A1 - Biermann-Stallwitz, Janine A1 - Joos, Stefanie A1 - Sturm, Heidrun A1 - Metz, Brigitte A1 - Auer, Ramona A1 - Skrobik, Yoanna A1 - Eschweiler, Gerhard W. A1 - Rapp, Michael Armin T1 - Patient safety, cost-effectiveness, and quality of life BT - reduction of delirium risk and postoperative cognitive dysfunction after elective procedures in older adults—study protocol for a stepped-wedge cluster randomized trial (PAWEL Study) JF - Trials N2 - Background Postoperative delirium is a common disorder in older adults that is associated with higher morbidity and mortality, prolonged cognitive impairment, development of dementia, higher institutionalization rates, and rising healthcare costs. The probability of delirium after surgery increases with patients’ age, with pre-existing cognitive impairment, and with comorbidities, and its diagnosis and treatment is dependent on the knowledge of diagnostic criteria, risk factors, and treatment options of the medical staff. In this study, we will investigate whether a cross-sectoral and multimodal intervention for preventing delirium can reduce the prevalence of delirium and postoperative cognitive decline (POCD) in patients older than 70 years undergoing elective surgery. Additionally, we will analyze whether the intervention is cost-effective. Methods The study will be conducted at five medical centers (with two or three surgical departments each) in the southwest of Germany. The study employs a stepped-wedge design with cluster randomization of the medical centers. Measurements are performed at six consecutive points: preadmission, preoperative, and postoperative with daily delirium screening up to day 7 and POCD evaluations at 2, 6, and 12 months after surgery. Recruitment goals are to enroll 1500 patients older than 70 years undergoing elective operative procedures (cardiac, thoracic, vascular, proximal big joints and spine, genitourinary, gastrointestinal, and general elective surgery procedures. Discussion Results of the trial should form the basis of future standards for preventing delirium and POCD in surgical wards. Key aims are the improvement of patient safety and quality of life, as well as the reduction of the long-term risk of conversion to dementia. Furthermore, from an economic perspective, we expect benefits and decreased costs for hospitals, patients, and healthcare insurances. Trial registration German Clinical Trials Register, DRKS00013311. Registered on 10 November 2017. KW - Cross-sectoral care KW - Delirium prevention KW - Postoperative cognitive dysfunction KW - Dementia KW - Older patients KW - Elective surgery KW - Quality of life KW - Cost-effectiveness Y1 - 2019 U6 - https://doi.org/10.1186/s13063-018-3148-8 SN - 1468-6694 SN - 1745-6215 SN - 1468-6708 VL - 20 IS - 71 PB - BioMed Central CY - London ER -