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Systematic care for caregivers of patients with dementia: a multicenter, cluster-randomized, controlled trial


Spijker, Anouk, Wollersheim, Hub, Teerenstra, Steven, Graff, Maud, Adang, Eddy, Verhey, Frans, Vernooij-Dassen, Myrra


The American Journal Of Geriatric Psychiatry: Official Journal Of The American Association For Geriatric Psychiatry, Volume: 19, No.: 6, Pages.: 521-531

Year of Publication



Objective: To evaluate the effectiveness of the Systematic Care Program for Dementia (SCPD) on patient institutionalization and to determine the predictors of institutionalization.; Design: Single-blind, multicenter, cluster-randomized, controlled trial.; Setting: Six community mental health services (CMHSs) across the Netherlands.; Participants: A total of 295 patient-caregiver dyads referred to a CMHS with suspected patient dementia.; Intervention: Training of health professionals in the SCPD and its subsequent use. The SCPD consists of a systematic assessment of caregiver problems and alerts health professionals in flexible, connecting, proactive interventions to them. The intensity of the SCPD depends on the judgment of the health professional, based on individual caregiver needs.; Primary Outcome: Institutionalization in long-term care facilities at 12 months of follow-up.; Results: No main intervention effect on institutionalization was found. However, a better sense of competence in the control group reduced the chance of institutionalization but not in the intervention group. The caregiver’s sense of competence and depressive symptoms and the patient’s behavioral problems and severity of dementia were the strongest predictors of institutionalization. The intensity of the program was low, even for dyads exposed to the SCPD.; Conclusions: Although no main effect was found, the results suggest that the SCPD might prevent a deterioration of the sense of competence in the intervention group. The intensity of a program is crucial and should be prescribed on the basis of evidence rather than left to the discretion of health professionals. Future controlled trials in daily clinical practice should use a process analysis to control for compliance.;

Bibtex Citation

@article{Spijker_2011, doi = {10.1097/jgp.0b013e3182110599}, url = {}, year = 2011, month = {jun}, publisher = {Elsevier {BV}}, volume = {19}, number = {6}, pages = {521--531}, author = {Anouk Spijker and Hub Wollersheim and Steven Teerenstra and Maud Graff and Eddy Adang and Frans Verhey and Myrra Vernooij-Dassen}, title = {Systematic Care for Caregivers of Patients With Dementia: A Multicenter, Cluster-Randomized, Controlled Trial}, journal = {The American Journal of Geriatric Psychiatry} }


aged, aged, 80 and over, caregivers, community mental health services, competence, cost of illness, counseling, dementia, depression, female, humans, institutionalisation, institutionalization, male, methods, middle aged, nursing, psychology, statistics & numerical data, therapy

Countries of Study


Types of Dementia

Dementia (general / unspecified)

Types of Study

Randomised Controlled Trial

Type of Outcomes

Other, Service use or cost reductions (incl. hospital use reduction, care home admission delay)


Specialist Dementia Centre Care / Memory Clinic

Type of Interventions

Non-pharmacological Treatment, Workforce oriented interventions

Non-Pharmaceutical Interventions

Dementia advisor / Admiral nurses / Community Nursing

Workforce Interventions

Professional Training / Continuing Professional Development