RCTArchives of rehabilitation research and clinical translation2024

Randomized Trial to Evaluate Effects of Peer- and Clinician-Led Interventions for Caregivers of Individuals With Acquired Brain Injury.

Michael L Jones, Mariellen Jacobs, Claire Holley and 4 others

PMID 39372243

WHAT IT FOUND

Clinician-led problem-solving training reduced caregiver stress compared to usual care, with effects lasting three months.

Peer-led self-management showed no significant benefit on stress, depression, or self-efficacy, though a trend toward improved self-efficacy appeared. Engagement was low for both interventions.

Key findings

01Problem-Solving Training (PST) significantly reduced caregiver stress compared to Usual Care (UC) at two follow-up points.

02There were no significant differences between groups for depressive symptoms or caregiving self-efficacy.

03Engagement was low, with 23% of intervention participants not initiating sessions and only 53% completing all follow-up surveys.

STILL TO COME

How it was doneWhat they found

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What it does not show

The study did not reach its target sample size of 180 due to COVID-19 recruitment restrictions. A significant portion of participants (23%) in the intervention arms did not initiate the training, limiting the interpretation of efficacy. High attrition rates (47% loss to follow-up) and reliance on email surveys may have biased results. The BBC intervention was modified from group workshops to one-on-one sessions, which may have reduced its intended social support component. Trial registration occurred after enrollment began. Results may not generalize beyond caregivers of patients at this specific neurorehabilitation hospital.

Declared interests

The investigators reported no financial or nonfinancial disclosures.

The easy way to misread this

Do not conclude that peer-led interventions are ineffective for ABI caregivers. The BBC intervention was forced into a one-on-one format during the pandemic, removing the group support element central to its design, and engagement was very low.

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The study

Participants
169
Certainty of evidence
Moderate

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    Cite

    Michael L Jones, Mariellen Jacobs, Claire Holley, et al. Randomized Trial to Evaluate Effects of Peer- and Clinician-Led Interventions for Caregivers of Individuals With Acquired Brain Injury. Archives of rehabilitation research and clinical translation. 2024.

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