title: Peer support and reminiscence therapy for people with dementia and their family carers: a factorial pragmatic randomised trial.
abstract: OBJECTIVE
  The objective of this study was to evaluate peer support and reminiscence therapy, separately and together, in comparison with usual care for people with dementia and their family carers.
  
  
  METHODS
  Factorial pragmatic randomised trial, analysed by treatment allocated, was used for this study.
  
  
  METHODS
  The trial ran in Community settings in England.
  
  
  METHODS
  People with dementia and their family carers were the participants.
  
  
  METHODS
  Treatment as usual (TAU) plus one of the following: one-to-one peer support to family carers from experienced carers (Carer Supporter Programme; CSP), group reminiscence therapy (Remembering Yesterday, Caring Today; RYCT) for people with dementia and carers, both or neither.
  
  
  METHODS
  Primary outcomes included health-related quality of life (SF-12) for carers and quality of life (QoL-AD) for people with dementia; secondary outcomes included quality of relationship for carers and people with dementia; both were collected by blinded assessors at baseline, 5 and 12 months (primary end point).
  
  
  RESULTS
  Of 291 pairs recruited, we randomised 145 (50%) to CSP (71% uptake) and 194 (67%) to RYCT (61% uptake). CSP and RYCT, separately or together, were not effective in improving primary outcomes or most secondary outcomes. For CSP versus 'no CSP', adjusted difference in means was 0.52 points on the SF-12 (95% CI -1.28 to 2.32) and -0.08 points on the QoL-AD (95% CI -1.70 to 1.56). For RYCT versus 'no RYCT', the difference was 0.10 points on the SF-12 (95% CI -1.72 to 1.93) and 0.51 points on the QoL-AD (95% CI -1.17 to 2.08). However, carers reported better relationships with the people with dementia (difference 1.11, 95% CI 0.00 to 2.21, p=0.05). Comparison of combined intervention with TAU, and of intervention received, suggested differential impacts for carers and persons with dementia.
  
  
  CONCLUSIONS
  There is no evidence from the trial that either peer support or reminiscence is effective in improving the quality of life.
  
  
  BACKGROUND
  ISRCTN37956201; Results.
authors: UCL Research Department of Clinical, Educational and Health Psychology, London, UK.
authors: Georgina
authors: http://orcid.org/0000-0002-5278-1756
authors: G
authors: Charlesworth
authors: School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK.
authors: Karen
authors: K
authors: Burnell
authors: North East London NHS Foundation Trust, Ilford, UK.
authors: Nadia
authors: N
authors: Crellin
authors: NWORTH Clinical Trials Unit, Bangor University, Bangor, UK.
authors: Zoe
authors: Z
authors: Hoare
authors: Division of Psychiatry, University College London, London, UK.
authors: Juanita
authors: J
authors: Hoe
authors: London School of Economics, London, UK.
authors: Martin
authors: M
authors: Knapp
authors: Swansea University Medical School, Swansea, UK.
authors: Ian
authors: I
authors: Russell
authors: Division of Psychiatry, University College London, London, UK.
authors: Jennifer
authors: J
authors: Wenborn
authors: DSDC Wales, Bangor University, Bangor, UK.
authors: Bob
authors: B
authors: Woods
authors: Institute of Mental Health, University of Nottingham, Nottingham, UK.
authors: Martin
authors: M
authors: Orrell
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology* / Q000628:therapy*; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D008131:London; D008297:Male; D061212:Memory, Episodic; D008875:Middle Aged; D010379:Peer Group; D011613:Psychotherapy / Q000379:methods*; D011788:Quality of Life; D012944:Social Support