The Effects of a Blended Care Intervention in Partners of Patients With Acquired Brain Injury – Results of the CARE4Carer Randomized Controlled Trial

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The Effects of a Blended Care Intervention in Partners of Patients With Acquired Brain Injury – Results of the CARE4Carer Randomized Controlled Trial

• Jennifer J.E. Welten, MD
• Vincent C.M. Cox, PhD
• Ruben P.A. van Eijk, MD, PhD
• Caroline M. van Heugten, PhD
• Johanna M.A. Visser-Meily, MD, PhD
• Vera P.M. Schepers, MD, PhD

Open AccessPublished:September 08, 2023DOI:https://doi.org/10.1016/j.apmr.2023.08.024

Abstract

Objective

To assess effects of the CARE4Carer blended care intervention on caregiver mastery and psychosocial functioning compared with usual care in partners of patients with acquired brain injury (ABI).

Design

Multicenter randomized controlled trial.

Setting

Nine sites for rehabilitation medicine.

Participants

120 partners of outpatients with ABI were randomly allocated to blended care (N=59) or usual care (N=61).

Intervention

The blended care intervention (20 weeks) was aimed at improving caregiving skills and consisted of 9 online sessions, combined with 2 face-to-face consultations with a social worker.

Main Outcome Measures

Mastery was assessed with the Caregiver Mastery Scale, secondary outcome measures were caregiver strain (Caregiver Strain Index), family functioning (Family Assessment Device), anxiety and depression (Hospital Anxiety and Depression Scale), burden (self-rated), and quality of life (CarerQol). Assessments were performed at baseline, 24, and 40 weeks.

Results

The adjusted mean difference in caregiver mastery between intervention and control group at week 24 was 1.31 (SD3.48, 95% confidence interval (CI) -0.12 to 2.74, P=.072) and at week 40 was 1.31 (SD3.69, 95% CI -0.26 to 2.88, P=.100). In the per protocol analysis, the adjusted mean difference in caregiver mastery at week 24 was 1.53 (SD3.38, 95% CI 0.10 to 2.96, P=.036) and at week 40 was 1.57 (SD3.63, 95% CI 0.01 to 3.14, P=.049). Regarding secondary outcomes, caregiver strain was lower in the intervention group in the per protocol analysis at week 40. Family functioning was higher in the intervention group in week 24, whereas anxiety was lower at both timepoints.

Conclusions

In the subset of participants who were able to complete the intervention, caregiver mastery and psychosocial functioning improved. Future work should focus on improving adherence as this will optimize beneficial effects of blended care.