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Kahan BC, Hindley J, Edwards M, Cro S, Morris TP. The estimands framework: a primer on the ICH E9(R1) addendum. BMJ 2024; 384:e076316. [PMID: 38262663 PMCID: PMC10802140 DOI: 10.1136/bmj-2023-076316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/07/2023] [Indexed: 01/25/2024]
Affiliation(s)
- Brennan C Kahan
- MRC Clinical Trials Unit at UCL, University College London, London WC1V 6LJ, UK
| | - Joanna Hindley
- MRC Clinical Trials Unit at UCL, University College London, London WC1V 6LJ, UK
| | - Mark Edwards
- Department of Anaesthesia, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Southampton NIHR Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Suzie Cro
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, London, UK
| | - Tim P Morris
- MRC Clinical Trials Unit at UCL, University College London, London WC1V 6LJ, UK
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Baker FA, Pac Soo V, Bloska J, Blauth L, Bukowska AA, Flynn L, Hsu MH, Janus E, Johansson K, Kvamme T, Lautenschlager N, Miller H, Pool J, Smrokowska-Reichmann A, Stensæth K, Teggelove K, Warnke S, Wosch T, Odell-Miller H, Lamb K, Braat S, Sousa TV, Tamplin J. Home-based family caregiver-delivered music and reading interventions for people living with dementia (HOMESIDE trial): an international randomised controlled trial. EClinicalMedicine 2023; 65:102224. [PMID: 38106552 PMCID: PMC10725050 DOI: 10.1016/j.eclinm.2023.102224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/24/2023] [Accepted: 09/05/2023] [Indexed: 12/19/2023] Open
Abstract
Background Music interventions provided by qualified therapists within residential aged care are effective at attenuating behavioural and psychological symptoms (BPSD) of people with dementia (PwD). The impact of music interventions on dementia symptom management when provided by family caregivers is unclear. Methods We implemented a community-based, large, pragmatic, international, superiority, single-masked randomised controlled trial to evaluate if caregiver-delivered music was superior to usual care alone (UC) on reducing BPSD of PwD measured by the Neuropsychiatric Inventory-Questionnaire (NPI-Q). The study included an active control (reading). People with dementia (NPI-Q score ≥6) and their caregiver (dyads) from one of five countries were randomly allocated to caregiver-delivered music, reading, or UC with a 1:1:1 allocation stratified by site. Caregivers received three online protocolised music or reading training sessions delivered by therapists and were recommended to provide five 30-min reading or music activities per week (minimum twice weekly) over 90-days. The NPI-Q severity assessment of PwD was completed online by masked assessors at baseline, 90- (primary) and 180-days post-randomisation and analysed on an intention-to-treat basis using a likelihood-based longitudinal data analysis model. ACTRN12618001799246; ClinicalTrials.govNCT03907748. Findings Between 27th November 2019 and 7th July 2022, we randomised 432 eligible of 805 screened dyads (music n = 143, reading n = 144, UC n = 145). There was no statistical or clinically important difference in the change from baseline BPSD between caregiver-delivered music (-0.15, 95% CI -1.41 to 1.10, p = 0.81) or reading (-1.12, 95% CI -2.38 to 0.14, p = 0.082) and UC alone at 90-days. No related adverse events occurred. Interpretation Our findings suggested that music interventions and reading interventions delivered by trained caregivers in community contexts do not decrease enduring BPSD symptoms. Funding Our funding was provided by National Health and Medical Research Council, Australia; The Research Council of Norway; Federal Ministry of Education and Research, Germany; National Centre for Research and Development, Poland; Alzheimer's Society, UK, as part of the Joint Programme for Neurodegenerative Diseases consortia scheme.
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Affiliation(s)
- Felicity Anne Baker
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Australia
- Centre for Research in Music and Health, Norwegian Academy of Music, Norway
| | - Vanessa Pac Soo
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Australia
- MISCH (Methods and Implementation Support for Clinical Health) Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Jodie Bloska
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, United Kingdom
| | - Laura Blauth
- Institute for Applied Social Sciences, Music Therapy Lab, Technical University of Applied Sciences Würzburg-Schweinfurt, Germany
| | - Anna A. Bukowska
- Institute of Applied Sciences, University of Physical Education in Krakow, Poland
| | - Libby Flynn
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Australia
| | - Ming Hung Hsu
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, United Kingdom
| | - Edyta Janus
- Institute of Applied Sciences, University of Physical Education in Krakow, Poland
| | - Kjersti Johansson
- Centre for Research in Music and Health, Norwegian Academy of Music, Norway
| | - Tone Kvamme
- Centre for Research in Music and Health, Norwegian Academy of Music, Norway
| | - Nicola Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
- North Western Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Hayley Miller
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Australia
| | - Jonathan Pool
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, United Kingdom
| | | | - Karette Stensæth
- Centre for Research in Music and Health, Norwegian Academy of Music, Norway
| | - Kate Teggelove
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Australia
| | - Sven Warnke
- Institute for Applied Social Sciences, Music Therapy Lab, Technical University of Applied Sciences Würzburg-Schweinfurt, Germany
| | - Thomas Wosch
- Institute for Applied Social Sciences, Music Therapy Lab, Technical University of Applied Sciences Würzburg-Schweinfurt, Germany
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, United Kingdom
| | - Karen Lamb
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Australia
- MISCH (Methods and Implementation Support for Clinical Health) Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Sabine Braat
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Australia
- MISCH (Methods and Implementation Support for Clinical Health) Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Tanara Vieira Sousa
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Australia
| | - Jeanette Tamplin
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Australia
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