A new psychosocial goal-setting and manualised support intervention for independence in dementia (NIDUS-Family): longer-term outcomes of a randomised controlled trial.

BACKGROUND: The new psychosocial goal-setting and manualised support intervention for independence in dementia (NIDUS-Family) is a manualised dementia care intervention. AIMS: To evaluate whether goal-setting plus NIDUS-Family is more effective than the control condition (goal-setting and routine care) in supporting dyads' (family carers and care recipients with dementia) attainment of personalised goals; and to determine participant-perceived goal relevance over 24 months. METHOD: We randomised dyads from community settings (2:1): to NIDUS-Family, a manualised psychological intervention tailored to goals that dyads set by selecting modules, delivered in 6-8 video call/telephone sessions over 6 months then 2-3 follow-ups monthly for 6 months; or to control. Outcomes were goal attainment scaling (GAS) (primary) at 18 and 24 months, functioning, quality of life, time until care home admission or death, carer anxiety and depression. Primary analysis, a mixed-effects model, accounted for randomisation group, study site, time, intervention arm facilitator and repeated measurements. RESULTS: In the period 2020-2021, 204 participants were randomised to intervention and 98 to control; 164 (54.3%) and 141 (46.7%) dyads completed 18- and 24-month outcomes, respectively.In the primary analysis, including 277 participants contributing 6-, 12-, 18- or 24-month outcomes, adjusted GAS mean differences (intervention-control) at 18 and 24 months were 11.78 (95% CI 6.64, 16.93) and 8.67 (95% CI 3.31, 14.02), respectively. Secondary outcome comparisons were not significant. The hazard ratio for dying or care home admission was 0.80 (95% CI 0.45, 1.42; intervention versus control), and 0.87 (95% CI 0.41, 1.82) and 0.59 (95% CI 0.26, 1.33) for death and care home admission, respectively. Among baseline GAS goals, carers considered 436 (78.0%) relevant at 18 months and 383 (78.5%) at 24 months. CONCLUSIONS: NIDUS-Family improved attainment of GAS goals over 2 years. TRIAL REGISTRATION NUMBER: ISRCTN11425138.