RESEARCH ARTICLE An intervention to reduce neuropsychiatric symptoms and caregiver burden in dementia: Preliminary results from a randomized trial of the tailored activity program–outpatient version Alexandra Martini de Oliveira 2 | Marcia Radanovic 2 | Patricia Cotting Homem de Mello 1 | Patricia Cardoso Buchain 1 | Adriana Dias Vizzotto 1 | Janaína Harder 3 | Florindo Stella 2 | Catherine Verrier Piersol 4 | Laura N. Gitlin 5 | Orestes Vicente Forlenza 2 1 Serviço de Terapia Ocupacional, Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil 2 Laboratório de Neurociencias (Lim 27), Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil 3 Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil 4 Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania 5 College of Nursing and Health Professions (CNHP), Dexel University, Philadelphia, Pennsylvania Correspondence Alexandra Martini de Oliveira, Laboratory of Neuroscience (LIM‐27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, 05403-010 São Paulo, SP, Brazil. Email: xandamartini@usp.br Funding information National Council for Scientific and Techno- logical Development, Grant/Award Numbers: 466625/2014‐6 and 442795/2014‐9; Sao Paulo Research Foundation, Grant/Award Numbers: 2016/01302‐9, 2014/14211‐6 and 09/52825‐8; Alzira Denise Hertzog Silva Association (ABADHS) Objective: To evaluate the efficacy of the tailored activity program–outpatient version (TAP‐O) and to reduce neuropsychiatric symptoms (NPS) in patients with dementia and caregiver burden compared with a control group (psychoeducation intervention). Methods: Twenty‐one persons with dementia and their caregivers were recruited and randomized. The intervention group received TAP‐O, designed for outpatients with dementia and their caregivers. TAP‐O consisted of eight sessions in which an occupational therapist assessed the patient's abilities and interests; prescribed tailored activities; and educated caregivers about dementia, NPS, and how to imple- ment meaningful activities in the daily routine. The control group received eight ses- sions of a psychoeducation intervention about dementia and NPS. Results: Compared with controls, patients receiving TAP‐O had a significant decrease in hallucination (P = 0.04), agitation (P = 0.03), anxiety (P = 0.02), aggression (P = 0.01), sleep disorder (P = 0.02), aberrant motor behavior (P = 0.02), and in care- giver burden (P = 0.003). Conclusions: Findings suggest that TAP‐O may be an effective nonpharmacological strategy to reduce NPS of outpatients with dementia and to minimize caregiver burden. KEYWORDS caregiver burden, dementia, family caregiving, neuropsychiatric behaviors, nonpharmacologic intervention, occupational therapy 1 | INTRODUCTION Although dementia is generally characterized by progressive cognitive and functional impairment, a key clinical feature is neuro- psychiatric symptoms (NPSs). 1 These symptoms are heterogeneous and may include agitation, shadowing, aggressiveness, apathy, sleep disorders, resistance to perform daily activities, delusions, hallucina- tions, and appetite changes. 1-3 Neuropsychiatric symptoms affect up to 90% of all persons living with dementia over the course of their illness and, if untreated, may worsen cognitive and daily func- tioning, accelerate long‐term hospitalization, and increase health care costs. 4,5 For caregivers, the presence of NPS is related to increased Received: 13 December 2017 Accepted: 17 June 2018 DOI: 10.1002/gps.4958 Int J Geriatr Psychiatry. 2018;1–7. © 2018 John Wiley & Sons, Ltd. wileyonlinelibrary.com/journal/gps 1