Randomized controlled trial of iSupport: Comparison across seven countries

Abstract

AbstractBackgroundWorld Health Organization (WHO) has developed iSupport for Dementia carers, an online program that aims to improve caregivers’ knowledge and skills, reduce emotional distress and improve the quality of life for both person with dementia and their caregivers. The program has been translated and culturally adapted in 33 countries and randomized controlled trials (RCTs) have been and are being conducted to evaluate effectiveness in Australia and Greater China, Brazil, India, the Netherlands, Portugal, the UK and Japan. We aim to compare and review RCTs protocols and key findings in those countries.MethodProtocols of seven RCTs evaluating the clinical and cost effectiveness of iSupport, and available outcomes data were reviewed and compared.ResultDelivery methods varied across countries ranging from caregivers’ self‐study using iSupport manual to a multicomponent intervention that engaged caregivers in iSupport and provided concomitant support from peers and facilitators. Control conditions also varied allocating the participants to either a waiting list or a control intervention. Sample sizes were between 42 to 390. Data were collected at three time‐points: baseline, three and six or nine months post baseline. The primary outcome was one or a combination of burden, depression, anxiety, health‐related quality of life, and stress. Secondary outcomes included depression, anxiety, quality of life, care recipient outcomes, positive aspects of caregiving, person‐centered attitude, self‐efficacy, mastery, resilience and dementia knowledge. In India, significant improvement was only seen in caregivers' person‐centered attitude towards persons with dementia in the iSupport group. Findings from interim data analysis in Australia and Greater China indicate that the iSupport group significantly improved the mental health component of quality of life, self‐efficacy, and reactions to care recipients’ memory and behavioural problems. The retention rate at 3 months were 36.42% in India, 82% in the UK, 85% in Australia and Greater China and 90.1% in Japan (interim analysis).ConclusionSome of the RCTs are still ongoing and results are expected soon. Preliminary data suggest that iSupport could be beneficial for both caregivers and recipients.