Characteristics of cognitive behavioral therapy for older adults living in residential care: Protocol for a systematic review

Background: The prevalence rates of depressive and anxiety disorders are high in residential aged care settings. Older adults in such settings might be prone to these disorders because of losses associated with transitioning to residential care, uncertainty about the future, as well as a decline in personal autonomy, health, and cognition. Cognitive behavioral therapy (CBT) is efficacious in treating late-life depression and anxiety. However, there remains a dearth of studies examining CBT in residential settings compared with community settings. Typically, older adults living in residential settings have higher care needs than those living in the community. To date, no systematic reviews have been conducted on the content and the delivery characteristics of CBT for older adults living in residential aged care settings. Objective: The objective of this paper is to describe the systematic review protocol on the characteristics of CBT for depression and/or anxiety for older adults living in residential aged care settings. Methods: This protocol was developed in compliance with the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Studies that fulfill the inclusion criteria will be identified by systematically searching relevant electronic databases, reference lists, and citation indexes. In addition, the PRISMA flowchart will be used to record the selection process. A pilot-tested data collection form will be used to extract and record data from the included studies. Two reviewers will be involved in screening the titles and abstracts of retrieved records, screening the full text of potentially relevant reports, and extracting data. Then, the delivery and content characteristics of different CBT programs of the included studies, where available, will be summarized in a table. Furthermore, the Downs and Black checklist will be used to assess the methodological quality of the included studies. Results: Systematic searches will commence in May 2018, and data extraction is expected to commence in July 2018. Data analyses and writing will happen in October 2018. Conclusions: In this section, the limitations of the systematic review will be outlined. Clinical implications for treating late-life depression and/or anxiety, and implications for residential care facilities will be discussed

SPIRIT 2013 checklist: Recommended items to address in a clinical trial protocol and related documents*.

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Primary and secondary outcome measures by time interval.

Primary and secondary outcome measures by time interval.</p

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SPIRIT schedule of enrolment, interventions, and assessments.

*-t1 = Baseline assessment. NOTE: GAI-20 = Geriatric Anxiety Inventory-20 items; GDS-30 = Geriatric Depression Scale-30 items; DSI-S = Depressive Symptoms Inventory–Suicide Subscale; ADIS-5 = The Anxiety Disorders Interview Schedule 5th edition; DJGLS-1 1 = De Jong Gierveld Loneliness Scales-11 items; LSNS = Lubben Social Network Scale; ACPQ-12 = Australian Community Participation Questionnaire-12 items; PID-5–BF = The Personality Inventory for DSM-5 Brief Form; HAq-II = Helping Alliance Questionnaire; AQoL = Assessment of Quality of Life; iPCQ = iMTA Productivity Cost Questionnaire. aMeasures will be administered over the phone, online or paper based (participant’s choice).</p