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. 2017 Oct 20:12:1779-1789.
doi: 10.2147/CIA.S143006. eCollection 2017.

Psychosocial therapy for Parkinson's-related dementia: intervention development

Sheree A McCormick #  1   2 , Kathryn R McDonald #  1   2 , Sabina Vatter  1   2   3 , Vasiliki Orgeta  4 , Ellen Poliakoff  1   2 , Sarah J Smith  5 , Iracema Leroi  1   2   3
Affiliations

Psychosocial therapy for Parkinson's-related dementia: intervention development

Sheree A McCormick et al. Clin Interv Aging. .

Abstract

Background: Group-based psychosocial therapy, such as group Cognitive Stimulation Therapy, improves cognition and quality of life in people living with dementia. Neuropsychiatric symptoms and restricted mobility are common complications for people with Parkinson's-related dementia (PRD) and may limit access to, and participation in, group activities. This study describes the development of a condition-specific, home-based psychosocial therapy for people with PRD ready to be trialled in a clinical population.

Methods: By means of a multistage process, a draft therapy manual was developed in an iterative manner through collaboration with medical experts, researchers and Patient and Public Involvement (PPI) representatives. In stage 1, an extensive literature search of psychosocial therapies for dementia with potential relevance for Parkinson's disease (PD) was undertaken to select a candidate therapy for adaptation. In stage 2, qualitative feedback from stakeholders and intelligence regarding existing nonpharmacological therapies for cognitive impairment in PD was combined to produce a prototype therapy manual. In stage 3, the manual was field tested in: 1) a home-setting using a 25-item assessment tool; and 2) at a local PD support group with PPI representatives. Based on the feedback from this phase, final design modifications were implemented and a draft therapy manual produced.

Results: The manual was developed in an iterative manner. Interview and focus group transcripts identified three enduring themes: manual form and content, therapy acceptability by people with PRD, and companion guidance and support. Major adaptations included: removal of discrete levels of task complexity, removal of images that were potentially hallucinogenic or lacked clarity, and updating of the content.

Conclusion: We have successfully developed a Cognitive Stimulation Therapy-based psychosocial therapy specifically adapted for people with PRD. The therapy is ready to trial in a pilot randomized controlled study.

Keywords: MRC framework; Parkinson’s disease; cognitive stimulation; intervention development.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The user-driven development framework adopted during the development of CST adapted for people with Parkinson’s-related dementias (CST-PD). Abbreviations: CST, Cognitive Stimulation Therapy; iCST, individual Cognitive Stimulation Therapy; MCST, Maintenance Cognitive Stimulation Therapy; PD, Parkinson’s disease; RCT, randomized controlled trial.
See this image and copyright information in PMC

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