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Family Caregiver Skills Training to Improve Experiences of Care: a Randomized Clinical Trial.

Publication ,  Journal Article
Van Houtven, CH; Smith, VA; Lindquist, JH; Chapman, JG; Hendrix, C; Hastings, SN; Oddone, EZ; King, HA; Shepherd-Banigan, M; Weinberger, M
Published in: J Gen Intern Med
October 2019

OBJECTIVE: To evaluate the effectiveness of Helping Invested Families Improve Veterans' Experiences Study (HI-FIVES), a skills training program for caregivers of persons with functional or cognitive impairments. DESIGN: A two-arm RCT. SETTING: Single Veterans Affairs Medical Center. PARTICIPANTS: Patients and their primary caregivers referred in the past 6 months to home and community-based services or geriatrics clinic. INTERVENTION: All caregivers received usual care. Caregivers in HI-FIVES also received five training calls and four group training sessions. MAIN MEASURES: Cumulative patient days at home 12 months post-randomization, defined as days not in an emergency department, inpatient hospital, or post-acute facility. Secondary outcomes included patients' total VA health care costs, caregiver and patient rating of the patient's experience of VA health care, and caregiver depressive symptoms. RESULTS: Of 241 dyads, caregivers' (patients') mean age was 61 (73) years, 54% (53%) Black and 89% (4%) female. HI-FIVES was associated with a not statistically significant 9% increase in the rate of days at home (95% CI 0.72, 1.65; mean difference 1 day over 12 months). No significant differences were observed in health care costs or caregiver depressive symptoms. Model-estimated mean baseline patient experience of VA care (scale of 0-10) was 8.43 (95% CI 8.16, 8.70); the modeled mean difference between HI-FIVES and controls at 3 months was 0.29 (p = .27), 0.31 (p = 0.26) at 6 months, and 0.48 (p = 0.03) at 12 months. For caregivers, it was 8.34 (95% CI 8.10, 8.57); the modeled mean difference at 3 months was 0.28 (p = .18), 0.53 (p < .01) at 6 months, and 0.46 (p = 0.054) at 12 months. CONCLUSIONS: HI-FIVES did not increase patients' days at home; it showed sustained improvements in caregivers' and patients' experience of VA care at clinically significant levels, nearly 0.5 points. The training holds promise in increasing an important metric of care quality-reported experience with care.

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Published In

J Gen Intern Med

DOI

EISSN

1525-1497

Publication Date

October 2019

Volume

34

Issue

10

Start / End Page

2114 / 2122

Location

United States

Related Subject Headings

  • Veterans
  • United States Department of Veterans Affairs
  • United States
  • Quality of Health Care
  • Middle Aged
  • Male
  • Humans
  • Health Care Costs
  • General & Internal Medicine
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Van Houtven, C. H., Smith, V. A., Lindquist, J. H., Chapman, J. G., Hendrix, C., Hastings, S. N., … Weinberger, M. (2019). Family Caregiver Skills Training to Improve Experiences of Care: a Randomized Clinical Trial. J Gen Intern Med, 34(10), 2114–2122. https://doi.org/10.1007/s11606-019-05209-x
Van Houtven, Courtney Harold, Valerie A. Smith, Jennifer H. Lindquist, Jennifer G. Chapman, Cristina Hendrix, Susan Nicole Hastings, Eugene Z. Oddone, Heather A. King, Megan Shepherd-Banigan, and Morris Weinberger. “Family Caregiver Skills Training to Improve Experiences of Care: a Randomized Clinical Trial.J Gen Intern Med 34, no. 10 (October 2019): 2114–22. https://doi.org/10.1007/s11606-019-05209-x.
Van Houtven CH, Smith VA, Lindquist JH, Chapman JG, Hendrix C, Hastings SN, et al. Family Caregiver Skills Training to Improve Experiences of Care: a Randomized Clinical Trial. J Gen Intern Med. 2019 Oct;34(10):2114–22.
Van Houtven, Courtney Harold, et al. “Family Caregiver Skills Training to Improve Experiences of Care: a Randomized Clinical Trial.J Gen Intern Med, vol. 34, no. 10, Oct. 2019, pp. 2114–22. Pubmed, doi:10.1007/s11606-019-05209-x.
Van Houtven CH, Smith VA, Lindquist JH, Chapman JG, Hendrix C, Hastings SN, Oddone EZ, King HA, Shepherd-Banigan M, Weinberger M. Family Caregiver Skills Training to Improve Experiences of Care: a Randomized Clinical Trial. J Gen Intern Med. 2019 Oct;34(10):2114–2122.
Journal cover image

Published In

J Gen Intern Med

DOI

EISSN

1525-1497

Publication Date

October 2019

Volume

34

Issue

10

Start / End Page

2114 / 2122

Location

United States

Related Subject Headings

  • Veterans
  • United States Department of Veterans Affairs
  • United States
  • Quality of Health Care
  • Middle Aged
  • Male
  • Humans
  • Health Care Costs
  • General & Internal Medicine
  • Female