Psychosocial Interventions for Non-Professional Careers of People with Parkinson's Disease

AIM: This paper is a report of a scoping review to systematically identify and collate the evidence on psychosocial interventions for non-professional carers of people with Parkinson's disease. BACKGROUND: Carers are critical to people with Parkinson's disease maintaining independent living and quality of life. Parkinson's disease imposes a challenging constellation of symptoms and no summary of effective interventions for carers and their unique support needs exists. DATA SOURCES: Thirty electronic databases were searched from their inception to July 2006, and bibliographies and specific internet sites were scanned METHODS: Eligible studies were categorized according to design, type of economic evaluation where applicable, number of participants, country of evaluation, intervention, orientation, provider, setting, method of delivery, carer population, patient population, carer outcomes, patient outcomes and authors' conclusions. Data were extracted by one reviewer and checked by another reviewer; discrepancies were resolved through discussion or arbitration by a third reviewer. FINDINGS: Thirty studies met the inclusion criteria. Most investigated relatively unique interventions involving multiple elements; the majority were not aimed primarily at carers but were embedded in patient treatment programmes. Many were pilot studies, employing weak research designs and involving very small numbers of participants and most were not designed to assess the clinical or cost effectiveness of the intervention for the carers. CONCLUSION: Several interventions merit further investigation but there is currently little evidence to show which approaches are effective and cost effective in supporting carers. Future studies need to employ appropriate and rigorous research designs with adequate samples and outcome measures, and with more focus on the carer.