title: Do nurse-led skill training interventions affect informal caregivers' out-of-pocket expenditures?
abstract: OBJECTIVE
  This paper is a report of a study of the Assistance, Support, and Self-health Initiated through Skill Training (ASSIST) randomized control trial. The aim of this paper is to understand whether participating in ASSIST significantly changed the out-of-pocket (OOP) costs for family caregivers of Alzheimer's disease (AD) or Parkinson's disease (PD) patients.
  
  
  METHODS
  Secondary analysis of randomized control trial data, calculating average treatment effects of the intervention on OOP costs. Enrollment in the ASSIST trial occurred between 2002 and 2007 at 2 sites: Durham, North Carolina, and Birmingham, Alabama. We profile OOP costs for caregivers who participated in the ASSIST study and use 2-part expenditure models to examine the average treatment effect of the intervention on caregiver OOP expenditures.
  
  
  RESULTS
  ASSIST-trained AD and PD caregivers reported monthly OOP expenditures that averaged $500-$600. The intervention increased the likelihood of caregivers spending any money OOP by 26 percentage points over usual care, but the intervention did not significantly increase overall OOP costs.
  
  
  CONCLUSIONS
  The ASSIST intervention was effective and inexpensive to the caregiver in direct monetary outlays; thus, there are minimal unintended consequences of the trial on caregiver financial well-being.
authors.affiliation: Center of Excellence in Health Services Research in Primary Care, Durham VA, Durham, NC 27705, USA. courtney.vanhoutven@duke.edu
authors.forename: Courtney Harold
authors.initials: CH
authors.lastname: Van Houtven
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Thorpe
authors.forename: Deborah
authors.initials: D
authors.lastname: Chestnutt
authors.forename: Margory
authors.initials: M
authors.lastname: Molloy
authors.forename: John C
authors.initials: JC
authors.lastname: Boling
authors.forename: Linda Lindsey
authors.initials: LL
authors.lastname: Davis
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000191:economics / Q000451:nursing; D017028:Caregivers / Q000191:economics / Q000193:education* / Q000523:psychology; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D006266:Health Education; D005102:Health Expenditures; D006801:Humans; D007348:Insurance, Health; D008134:Long-Term Care / Q000191:economics*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010300:Parkinson Disease / Q000191:economics / Q000451:nursing; D012944:Social Support; D012959:Socioeconomic Factors