Impact of pharmaceutical care integrated at a psychosocial intervention to reduce caregiver's burden in Alzheimer's disease or related dementias: Negative results at 18 months and difficulties to conduct PHARMAID RCT.

Background: Psychosocial interventions for caregivers of patients with Alzheimer disease and relative dementias (ADRD) reported a caregiver burden improvement. Multicomponent intervention integrating pharmaceutical care has not yet been evaluated while ADRD patients and their caregivers are exposed to high risk of drug-related problems. The PHARMAID study aimed to assess the impact of personalized pharmaceutical care integrated to a psychosocial program on the burden of ADRD caregivers at 18 months. Methods: The PHARMAID RCT was conducted between September 2016 and June 2020 [ClinicalTrials.gov: NCT02802371]. PHARMAID study planned to enroll 240 dyads, i.e. ADRD patients and caregivers, whose inclusion criteria were: outpatient with mild or major neurocognitive disorders due to ADRD, living at home, receiving support from a family caregiver. Three parallel groups compared a control group with two interventional groups: psychosocial intervention and integrated pharmaceutical care at a psychosocial intervention. The main outcome was the caregiver burden assessed by the Zarit Burden Index (ZBI, score range 0-88) at 18 months. Results: Overall, 77 dyads were included (32% of the expected sample size). At 18 months, the mean ZBI scores were 36.7 ± 16.8 in the control group, 30.3 ± 16.3 for the group with psychosocial intervention, and 28.8 ± 14.1 in group with integrated pharmaceutical care at psychosocial intervention. No significant difference was demonstrated between the three groups (p = 0.326). Conclusions: The findings suggest that PHARMAID program had no significant impact on caregiver burden at 18 months. Several limitations have been highlighted and discussed by the authors in order to formulate recommendations for further research.

[« Forum Passerelle ¼: an opportunity for caregivers to meet the professionals of service and support in Alzheimer's disease and related diseases.] / « Forum Passerelle ¼ : une opportunité pour les proches aidants de rencontrer les professionnels des dispositifs d'aide et d'accompagnement dans le cadre de la maladie d'Alzheimer et maladies apparentées.

The aim of this study was to assess 1) the satisfaction of caregivers of patients with Alzheimer's disease or related diseases regarding a new collective support intervention called "Forum Passerelle"(Gateway forum), and 2) to assess the impact of "Forum Passerelle" on the implementation of services and support for patients or caregivers. This is an observational study carried out on the basis of 3 "Forum Passerelle" (between October 2018 and February 2020). Following each "Forum Passerelle", the caregivers' satisfaction was assessed and the number of services and support was counted. In total, 78 caregivers took part in these first "Forum passerelle". The satisfaction survey showed that 98% of caregivers were satisfied with the topics covered by "Forum Passerelle". The forum fully met the expectations of 61% of caregivers and partially for 39%. Among the caregivers contacted 3 or 6 months after the forum, 68% had set up a new service/support (85 new services/support for the sick relatives and 32 for caregivers) and 59% declared that these changes had taken place thanks to the "Forum Passerelle". To conclude, the first 3 "Forums Passerelle" were received very favorably by caregivers and contributed to the implementation of new services to optimize home support for the sick relative.