353 A Direct-to-Patient Mailing about Sedative-Hypnotics and Online CBT-I: Participant Reported Use of Study Materials

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A141-A141
Author(s):  
Selene Mak ◽  
Christi Ulmer ◽  
Chritopher Kaufman ◽  
Cathy Alessi ◽  
Jennifer Martin ◽  
...  
Keyword(s):  
Older Adults ◽  
Behavioral Therapy ◽  
Low Cost ◽  
Controlled Trial ◽  
Benzodiazepine Receptor ◽  
Sleep Education ◽  
Study Materials ◽  
Risk Of Falls ◽  
Sedative Hypnotics ◽  
Survey Responses

Abstract Introduction Cognitive behavioral therapy for insomnia (CBT-I) is recommended as first-line treatment for chronic insomnia disorder for all adults. Older adults are often prescribed sedative-hypnotics (e.g., benzodiazepine receptor agonists, BRAs) for insomnia, despite observational studies showing these medications increase risk of falls, fractures, and cognitive decline. In an ongoing randomized controlled trial, we are testing “Sleep EducatioN Information Sent Directly to Patients (SEND),” a novel program combining direct-to-patient mailing with information about access to an online CBT-I resource, compared to a similarly structured control condition. In the current study, we surveyed participants in both groups to examine their self-reported use of intervention or control materials. Methods In the larger trial, 1,672 Veteran participants (aged >=65 years, receiving care from a Colorado VA facility, and prescribed a BRA) were randomized to receive the SEND intervention brochure with information on how to access a free, anonymous online CBT-I resource (n=836) or control condition brochure with information about general sleep education (n=836). Six months after the initial brochure mailing, all participants were mailed a blinded survey querying participants’ recollection and use of the mailed materials. We used chi-squared tests to compare survey responses for SEND versus control groups. Results 354 surveys were returned by study participants (overall response rate: 21%; SEND: 172 [20%], control: 182 [22%]). Respondents were 94% male with mean age 71.7 years (no difference between groups). In the SEND group, 97 (56%) reported receiving the brochure, 18 (10%) visited the website, and 14 (8%) discussed the brochure with their provider. No significant differences between groups were observed in the number of participants who reported receiving the brochure (chi2=2.96, p=.085); visiting the website (chi2=0.0253, p=.874); or discussing the brochure with their provider (chi2=1.91, p=.167). Conclusion At 6-months follow-up, over half of participants recalled receiving a mailing about sedative-hypnotics. A modest number reported visiting the online CBT-I program and a similar number discussed the materials with their healthcare provider. Similar results between groups suggest successful blinding of the intervention and control participants. If successful, the SEND intervention may provide a low-touch, low-cost approach to address BRA over-use in some older adults. Support (if any):

scholarly journals Sleep Discrepancy in a Randomized Controlled Trial of Brief Behavioral Therapy for Chronic Insomnia in Older Adults

2020 ◽  
pp. 1-11 ◽  
Author(s):  
Wai Sze Chan ◽  
Natalie D. Dautovich ◽  
Joseph P.H. McNamara ◽  
Ashley Stripling ◽  
Joseph M. Dzierzewski ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Chronic Insomnia ◽  
Randomized Controlled

scholarly journals A tailored Internet-delivered modular intervention based on cognitive behavioral therapy for depressed older adults: a study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jonas Eimontas ◽  
Vilmantė Pakalniškienė ◽  
Ieva Biliunaite ◽  
Gerhard Andersson
Keyword(s):  
Older Adults ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Well Being ◽  
The Elderly ◽  
Waiting List ◽  
Cognitive Behavioral ◽  
Depression Symptoms ◽  
Link Type

Abstract Background Depression is most common among the elderly and is associated with major impairment. With limited accessible treatments available, remotely provided interventions are needed. Internet-based interventions have been proven effective for a number of mental and somatic health problems. However, the elderly population has received relatively limited attention in previous studies. This study aims to address this gap by investigating the effectiveness of a tailored Internet-delivered modular intervention based on cognitive behavioral therapy (CBT). Methods A minimum of 60 participants will be recruited and randomly assigned to groups in a two-armed parallel controlled trial with a waiting list. The intervention group will have access to an 8-week therapist-supported modular intervention. The waiting list group will be instructed to wait for 8 weeks and then granted access to the intervention for 8 weeks. Pre, post, and 3-, 12-, and 24-month follow-up assessments are planned for measuring changes in depression symptoms, anxiety symptoms, and psychological well-being using PHQ-9, GDS, GAD-7, and WHO-5. Primary outcomes of all the participants will be analyzed using the intention-to-treat principle, and within- and between-group effect sizes will be calculated. Discussion Internet-based interventions could help address the existing treatment gap for depressed older adults. However, to date, the effectiveness of Internet-based CBT (ICBT) for depressed older adults has only been tested in a few studies. This trial will demonstrate if Internet-based CBT is effective for this population when compared to a waiting list control. Further analysis of secondary outcomes and participant behavior in the intervention will potentially reveal effectiveness moderating factors. Trial registration ClinicalTrials.gov NCT04728204. Registered on 15 January 2021. https://www.clinicaltrials.gov/ct2/show/NCT04728204?term=NCT04728204&draw=2&rank=1

scholarly journals REDUCING DYSFUNCTIONAL BELIEFS ABOUT SLEEP PROVIDES LONG-TERM BENEFIT IN OLDER ADULTS WITH INSOMNIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S526-S527
Author(s):  
Yeonsu Song ◽  
Constance Fung ◽  
Joseph Dzierzewski ◽  
Michael Mitchell ◽  
Karen Josephson ◽  
...  
Keyword(s):  
Older Adults ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Severity Index ◽  
Post Treatment ◽  
Sleep Diary ◽  
Dysfunctional Beliefs ◽  
Long Term Impact ◽  
Beliefs And Attitudes

Abstract Cognitive behavioral therapy for insomnia (CBTI) is recommended as first-line treatment in older adults. Changing dysfunctional beliefs and attitudes about sleep is an important component of CBTI, but the long-term impact of these changes are unknown, particularly in older adults. Methods involved secondary analyses of data from a large randomized controlled trial comparing CBTI (provided in 5 weekly sessions) to sleep education control, among older veterans with insomnia (N=159, mean age 72.2 years, 97% male, 79% non-Hispanic white). The purpose was to examine whether changes in a validated scale of Dysfunctional Beliefs and Attitudes about Sleep (DBAS) with CBTI treatment (baseline to post-treatment) was associated with later changes in self-reported sleep (post-treatment to 6 months follow-up). Sleep measures included Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS) and 7-day sleep diary measures. Analyses compared the slope of change in DBAS (baseline to post-treatment) between CBTI and control with respect to the slope of change in sleep outcomes (post-treatment to 6-months). Compared to controls, the CBTI group had stronger associations between DBAS improvement (baseline to post-treatment) and subsequent PSQI improvement (post-treatment to 6-months) (difference in slopes=1.3, 95% CI=[.52,2.1], p=0.001). This pattern of significant results was also found for ISI (difference in slopes=1.8, 95% CI=[.58,3.0], p=0.004) and ESS (difference in slopes=1.0, 95% CI=[.25,1.7], p=0.009). Slopes were not different for sleep diary measures. These findings suggest that changing dysfunctional beliefs and attitudes may continue to confer sleep benefits well after completion of CBT-I in older adults.

scholarly journals EFFECTS OF MINDFUL FELDENKRAIS EXERCISES AND STRENGTH TRAINING ON COGNITIVE EXECUTIVE FUNCTION IN OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S649-S649
Author(s):  
Gerhild Ullmann ◽  
Yuhua Li ◽  
Meredith A Ray
Keyword(s):  
Older Adults ◽  
Executive Function ◽  
Cognitive Function ◽  
Strength Training ◽  
Group Intervention ◽  
Independent Living ◽  
Low Cost ◽  
Controlled Trial ◽  
Control Group ◽  
Post Intervention

Abstract Decline in cognitive function associated with aging is one of the greatest concerns of older adults and often leads to significant burden for individuals, families, and the health care system. This 3-arm randomized controlled trial (RCT) responds to the urgent need to identify strategies which can enhance and/or maintain cognitive vitality in older adults. The study is funded by the National Institute on Aging, and aims to examine the effects of both the mind-body exercise Feldenkrais and strength training on cognitive executive function in independent living older adults (N=90) age 65 to 85. Participants of the first wave (n=45) were randomized to a (1) Feldenkrais group, (2) strength training and (3) no-intervention control group. Intervention groups met twice a week for 12 weeks. Cognitive and physical performance measures of the NIH-Toolbox were used at baseline, post-intervention and at a 3-month follow-up. Results of changes in cognitive executive functions within and across groups will be presented. The findings will suggest if such interventions would be a viable low-cost option for older adults to maintain cognitive vitality and thereby impact the development of programs and guidelines for combatting decline in cognitive function.

scholarly journals Noisy galvanic vestibular stimulation (nGVS) combined with a multisensory balance programme in older adults with moderate to high falls risk: A feasibility study for an RCT (Preprint)

2021 ◽  
Author(s):  
Ruth McLaren ◽  
Paul F. Smith ◽  
Sue Lord ◽  
Preet Kamal Kaur ◽  
Yiwen Zheng ◽  
...  
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Randomised Controlled Trial ◽  
Postural Sway ◽  
Controlled Trial ◽  
Community Dwelling ◽  
Post Intervention ◽  
Double Support ◽  
Risk Of Falls ◽  
Randomised Controlled

UNSTRUCTURED Background: Reduced mobility and falls are common in older adults. Balance retraining programmes are effective in reducing falls and improving balance and mobility. Noisy galvanic stimulation (nGVS) is a low level electrical stimulation used to reduce the threshold for firing of vestibular neurons via a mechanism of stochastic resonance. We hypothesise that nGVS will enhance the effects of balance retraining in older adults at risk of falls. Methods: This 3- armed randomised controlled trial assesses the feasibility of augmenting balance retraining with nGVS. Community dwelling older adults at risk of falling will be randomly assigned to either an nGVS plus balance programme (nGVS group), sham plus balance programme (sham group) or a no treatment group (Control). Participants will attend the exercise group twice a week for 8 weeks with assessment of balance and gait pre-treatment, post-treatment and at 3-months post-intervention. Primary outcome measures include postural sway, measured by Centre of Pressure (COP) velocity, area and root mean square and gait parameters of speed, step width, step variability and double support time. Spatial memory will also be measured using the Triangle Completion and 4 Mountains Tests. Discussion: This study will evaluate the feasibility of using nGVS alongside balance retraining in older adults at risk of falls and will inform the design of a fully powered randomised controlled trial. Trial registration: This trial has been prospectively registered with the Australia New Zealand Clinical Trials Registry (ACTRN12620001172998) and has a UTN of U1111-1241-2231.

scholarly journals Night-to-Night Sleep Variability in Older Adults With Chronic Insomnia: Mediators and Moderators in a Randomized Controlled Trial of Brief Behavioral Therapy (BBT-I)

2017 ◽  
Vol 13 (11) ◽  
pp. 1243-1254 ◽  
Author(s):  
Wai Sze Chan ◽  
Jacob Williams ◽  
Natalie D. Dautovich ◽  
Joseph P.H. McNamara ◽  
Ashley Stripling ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Chronic Insomnia ◽  
Night Sleep ◽  
Randomized Controlled
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