Translating evidence to patient care through caregivers: a systematic review of caregiver-mediated interventions

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dc.contributor.authorFiest, Kirsten M.
dc.contributor.authorMcIntosh, Christiane Job
dc.contributor.authorDemiantschuk, Danielle
dc.contributor.authorLeigh, Jeanna Parsons
dc.contributor.authorStelfox, Henry T.
dc.date.accessioned2019-01-24T21:11:51Z
dc.date.available2019-01-24T21:11:51Z
dc.date.issued2018
dc.description.abstractBackground: Caregivers may promote the uptake of science into patient care and the practice of evidence-informed medicine. The purpose of this study was to determine whether caregiver-mediated (non-clinical caregiver-delivered) interventions are effective in improving patient, caregiver, provider, or health system outcomes. Methods: We searched the MEDLINE, Embase, PsycINFO, Cumulative Index of Nursing and Allied Health, and Scopus databases from inception to February 27, 2017. Interventions (with a comparison group) reporting on a quality improvement intervention mediated by a caregiver and directed to a patient, in all ages and patient-care settings, were selected for inclusion. A three-category framework was developed to characterize caregiver-mediated interventions: inform (e.g., provide knowledge), activate (e.g., prompt action), and collaborate (e.g., lead to interaction between caregivers and other groups [e.g., care providers]). Results: Fifty-six studies met the inclusion criteria, and 64% were randomized controlled trials (RCTs). The most commonly assessed outcomes were patient-(n = 40) and caregiver-oriented (n = 33); few health system-(n = 10) and provider-oriented (n = 2) outcomes were reported. Patient outcomes (e.g., satisfaction) were most improved by caregiver-mediated interventions that provided condition and treatment education (e.g., symptom management information) and practical condition-management support (e.g., practicing medication protocol). Caregiver outcomes (e.g., stressrelated/psychiatric outcomes) were most improved by interventions that activated caregiver roles (e.g., monitoring blood glucose) and provided information related to that action (e.g., why and how to monitor). The risk of bias was generally high, and the overall quality of the evidence was low-moderate, based on Grading of Recommendations Assessment Development and Evaluation ratings. Conclusions: There is a large body of research, including many RCTs, to support the use of caregiver-mediated interventions that inform and activate caregivers to improve patient and caregiver outcomes. Select caregiver-mediated interventions improve patient (inform-activate) and caregiver (inform-activate-collaborate) outcomes and should be considered by all researchers implementing patient-and family-oriented research.
dc.description.grantingagencyCanadian Institutes of Health Research
dc.identifier.citationFiest, K. M., McIntosh, C. J., Demiantschuk, D., Leigh, J. P., & Stelfox, H. T. (2018). Translating evidence to patient care through caregivers: a systematic review of caregiver-mediated interventions. BMC Medicine, 16(1). https://doi.org/10.1186/s12916-018-1097-4
dc.identifier.doi10.1186/s12916-018-1097-4
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/35771
dc.identifier.issn1741-7015
dc.identifier.otherCRD42016052509
dc.identifier.urihttp://hdl.handle.net/1880/109512
dc.publisherBMC
dc.publisher.departmentCritical Care Medicine
dc.publisher.facultyCumming School of Medicine
dc.publisher.hasversionPublished version
dc.publisher.policyhttps://www.biomedcentral.com/about/policies/access-to-articles
dc.rights©  The Author(s). 2018
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectSystematic review
dc.subjectCaregiver-mediated
dc.subjectQuality improvement
dc.subjectKnowledge translation
dc.subjectImplementation science
dc.subjectIntervention
dc.subjectReview
dc.subjectTranslational medical research
dc.titleTranslating evidence to patient care through caregivers: a systematic review of caregiver-mediated interventions
dc.typeReview
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