Summary of Evidence on Psychosocial Interventions for BPSD

Literature review: A systematic review was conducted (PUBMED, COCHRANE, WOS, PsycINFO, Psycarticles, Alzforum) of all interventions involving informal carers, either alone or with the patient, and having an outcome related to BPSD. The search was limited to the past 12 years. 
Guidelines, reports, meta-analyses, systematic reviews, randomised controlled trials, and clinical trials were included. Quality assessment based upon the SIGN criteria. Outcomes included the ability of the carer to prevent and manage BPSD and/or a decrease in BPSD using the NeuroPsychiatric Inventory and/or a decrease in antipsychotics prescriptions and/or a delay in institutionalisation and/or a decrease in the use of emergency services.

Results: 1 guideline, 2 reports, 12 meta-analyses or systematic reviews, 45 randomised controlled or clinical trials were analysed.

- There is a great heterogeneity of terms used in literature to describe Psychosocial Interventions (PSI).
- Based on the most recent literature, ALCOVE proposes to establish a terminology consensus and in doing so proposes classifying PSI for Carers & Patients, tailored to their respective needs, into 9 categories:

  1. Multicomponent (e.g. Psycho-Educational + home visit)*
  2. Psycho-educational programmes* 
  3. Skills training & Educational programmes focused on the disease, therapies, environment,… *
  4. Home-visit/Mobile team*
  5. Activity planning, environmental redesign, Socio-cultural programmes
  6. Technology-support for family carers (web or telephone support) 
  7. Self-care techniques for family carers (Cognitive Behavioural Therapy, stress management, coping with change as a result of caregiving)
  8. Peer-support group 
  9. Conference/Meeting

* Interventions demonstrated as effective on BPSD in the literature

- Effectiveness in the literature: The quality of intervention studies has improved over the last few years. There is strong evidence (level 1) that PSI are effective in decreasing BPSD and carers’ negative reactions to these symptoms. PSI have comparable effectiveness or are more effective than antipsychotics and are safer, having no side effects (level 1). All interventions are not equally effective on BPSD.