Feasibility and acceptability of a telephone-based ACT intervention for caregivers (TACTICs) of adults with Alzheimer's disease and related dementias (ADRD): a randomized pilot during the COVID-19 pandemic.

Abstract

Objectives: Examine the feasibility, acceptability, and preliminary effects of the Telephone Acceptance and Commitment Therapy Intervention for Caregivers (TACTICs) on dementia caregivers' anxiety, depression, caregiver burden, suffering, and anticipatory grief.

Method: A 2-arm pilot randomized trial with dementia caregivers ≥ 21 years old with clinically elevated anxiety or anxiety-related functional interference. Two cohorts were recruited at the beginning and end of the first year of the COVID-19 pandemic. Intervention participants received 6 telephone sessions delivered by a non-licensed interventionist and control participants received readings and a list of dementia caregiver support groups in their area. Outcomes were measured at baseline, post-intervention, and at 3 and 6 months. Feasibility was measured by enrollment rates, completion rates, and adherence to TACTICs by interventionists. Acceptability was measured with participant satisfaction surveys.

Results: TACTICs was feasible and acceptable with 96% enrollment, 98.6% adherence, 65.5% completion, and a mean satisfaction score of 9.35 out of 10 (SD 0.91). The TACTICs group showed clinically relevant reductions in anxiety post-intervention (SRM 4.1, 95% CI [2.4,5.8]), however reductions were not significantly different from the control group (p = 0.98).

Conclusion: Implementation of TACTICs during the COVID-19 pandemic was feasible and acceptable. The preliminary outcomes were not as strong as expected. The results will inform the design of future trials with larger samples.