Effectiveness of multicomponent support interventions on burden in alzheimer caregivers: Systematic review and meta-analysis

ABSTRACT Şentürk Kılıç, B., The Effectiveness of Multi-Component Support Programs for Alzheimer's Caregivers on Burden: A Systematic Review and Meta-Analysis, Hacettepe University Graduate School of Health Sciences Ph.D. Dissertation in Psychiatric Nursing, Ankara, 2024. This systematic review and meta-analysis aimed to evaluate the effectiveness of multi-component support programs on the caregiver burden of individuals caring for Alzheimer's patients. The research was conducted through searches in five databases (CENTRAL, CINAHL, PsycINFO, PubMed, WOS) from October 18 to November 28, 2021, and included English-language randomized controlled trials that met the inclusion criteria. Two researchers independently assessed the full-text reviews, risk of bias using the Cochrane 'Risk of Bias-2' tool, and evidence quality using the GRADE tool. Additional information was obtained by contacting study authors, and analyses were conducted when sufficient data were provided. Results were presented narratively in cases of insufficient data. The review included 8 studies overall, with 6 of these studies providing data on caregiver burden outcomes that were incorporated into the meta analysis. Among the 1147 participants, only one study was web-based, while the other seven interventions were conducted face-to-face. The components of the interventions were mainly educational, supportive, and skill-building, with only one intervention including respite care. Overall risk of bias assessment recorded one study with high risk, four with unclear risk, and one with low risk. The effect sizes of the interventions were calculated based on the means and standard deviations of caregiver burden scores before and after the intervention, as well as follow-up measurements. The multi-component intervention programs were found to have an uncertain short-term effect (Cohen's d = 0.12; 95% CI: -0.06 - 0.29; p = 0.39) but were effective in the long term (Cohen's d = 0.21; 95% CI: 0.03 - 0.38; p = 0.02). The certainty of evidence for caregiver burden outcomes was determined to be low before the intervention and follow-up, and very low from pre-intervention to post-intervention measurements. The data is current as of 12/12/2023. Multi-component support programs are effective in reducing caregiver burden for Alzheimer's caregivers in the long term; however, more high-quality studies are needed to confirm this effectiveness. Keywords: Alzheimer's, caregiver, burden, multi-component intervention, meta-analysis