Evaluating the effects of the World Health Organization's online intervention ‘iSupport’ to reduce depression and distress in dementia carers: a multi-centre six-month randomised controlled trial in the UKResearch in context
Summary: Background: Sustaining the capabilities of dementia carers is a global priority. ‘iSupport’ is a self-guided online intervention designed by the World Health Organization (WHO) to reduce mental health problems in dementia carers. iSupport is undergoing global implementation, however there...
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Elsevier
2025-01-01
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| Series: | The Lancet Regional Health. Europe |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S266677622400293X |
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| author | Gill Windle Greg Flynn Zoe Hoare Nia Goulden Rhiannon Tudor Edwards Bethany Anthony Patricia Masterson Algar Suman Kurana Aimee Spector Gwenllian Hughes Ryan Innes John Connaghan Danielle Proctor Fatene Abakar Ismail Kiara Jackson Kieren Egan Joshua Stott |
| author_facet | Gill Windle Greg Flynn Zoe Hoare Nia Goulden Rhiannon Tudor Edwards Bethany Anthony Patricia Masterson Algar Suman Kurana Aimee Spector Gwenllian Hughes Ryan Innes John Connaghan Danielle Proctor Fatene Abakar Ismail Kiara Jackson Kieren Egan Joshua Stott |
| author_sort | Gill Windle |
| collection | DOAJ |
| description | Summary: Background: Sustaining the capabilities of dementia carers is a global priority. ‘iSupport’ is a self-guided online intervention designed by the World Health Organization (WHO) to reduce mental health problems in dementia carers. iSupport is undergoing global implementation, however there is an absence of effectiveness evidence. This study tested the effectiveness of iSupport to reduce distress and depression in dementia carers. Methods: A pragmatic randomised controlled trial was conducted in three centres. Adult carers (18+) living in the community were recruited in England, Wales and Scotland and randomly assigned (1:1) through a web-based system to iSupport or usual care. Outcome assessors were masked to allocation. The primary outcomes assessed the difference in distress and depression between baseline and six-months. The target sample size was 350 to enable 90% power, significance at 2.5% including 25% attrition (262 completers) on either outcome. Analysis followed the intention-to-treat (ITT) principle. The trial was registered with ISRCTN registry (17420703). Findings: Between 12th November 2021 and 31st March 2023,177 carers (50.3%) were randomised to usual care and 175 (49.7%) to iSupport. 263 (74.7%) completed the trial. All were included in the ITT analysis. Mean distress scores at six-months were 20.0 (SD = 8.3) for usual care and 20.6 (SD = 8.6) for iSupport. The mean difference was 0.16 (95% CI −1.17 to 1.49, p = 0.29) after adjusting for covariates. Mean depression scores at six-months were 9.5 (SD = 7.0) for usual care and 9.8 (SD = 6.5) for iSupport. The mean difference at six-months was −0.54 (95% CI = −1.70 to 0.62, p = 0.44). No serious adverse events were linked to the trial. Interpretation: To our knowledge this is the largest trial evaluating a self-guided online intervention in UK dementia carers, and the first to successfully evaluate the effectiveness of iSupport. The null findings are significant given the ongoing global implementation of iSupport by the WHO and the adoption of self-guided interventions into mainstream care delivery as part of digital health transformations. Funding: NIHR. |
| format | Article |
| id | doaj-art-be1c48a7be48412f8c7488e03ad47cf3 |
| institution | Kabale University |
| issn | 2666-7762 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Europe |
| spelling | doaj-art-be1c48a7be48412f8c7488e03ad47cf32024-11-21T06:06:40ZengElsevierThe Lancet Regional Health. Europe2666-77622025-01-0148101125Evaluating the effects of the World Health Organization's online intervention ‘iSupport’ to reduce depression and distress in dementia carers: a multi-centre six-month randomised controlled trial in the UKResearch in contextGill Windle0Greg Flynn1Zoe Hoare2Nia Goulden3Rhiannon Tudor Edwards4Bethany Anthony5Patricia Masterson Algar6Suman Kurana7Aimee Spector8Gwenllian Hughes9Ryan Innes10John Connaghan11Danielle Proctor12Fatene Abakar Ismail13Kiara Jackson14Kieren Egan15Joshua Stott16Dementia Services Development Centre Wales (DSDC Wales), School of Health Sciences, Bangor University, Wales, UK; Corresponding author. DSDC Wales, School of Health Sciences, Ardudwy, Holyhead Road, Bangor University, Gwynedd Wales, UK.North Wales Organisation for Randomised Trials in Health (NWORTH), North Wales Medical School, Bangor University, Wales, UKNorth Wales Organisation for Randomised Trials in Health (NWORTH), North Wales Medical School, Bangor University, Wales, UKNorth Wales Organisation for Randomised Trials in Health (NWORTH), North Wales Medical School, Bangor University, Wales, UKCentre for Health Economics & Medicines Evaluation (CHEME), School of Health Sciences, Bangor University, Wales, UKCentre for Health Economics & Medicines Evaluation (CHEME), School of Health Sciences, Bangor University, Wales, UKDementia Services Development Centre Wales (DSDC Wales), School of Health Sciences, Bangor University, Wales, UKDepartment of Clinical, Educational and Health Psychology, University College London, England, UKDepartment of Clinical, Educational and Health Psychology, University College London, England, UKDementia Services Development Centre Wales (DSDC Wales), School of Health Sciences, Bangor University, Wales, UKDepartment of Computer and Information Science, University of Strathclyde, Glasgow, Scotland, UKDepartment of Computer and Information Science, University of Strathclyde, Glasgow, Scotland, UKDepartment of Clinical, Educational and Health Psychology, University College London, England, UKDepartment of Computer and Information Science, University of Strathclyde, Glasgow, Scotland, UKDementia Services Development Centre Wales (DSDC Wales), School of Health Sciences, Bangor University, Wales, UKDepartment of Computer and Information Science, University of Strathclyde, Glasgow, Scotland, UKDepartment of Clinical, Educational and Health Psychology, University College London, England, UKSummary: Background: Sustaining the capabilities of dementia carers is a global priority. ‘iSupport’ is a self-guided online intervention designed by the World Health Organization (WHO) to reduce mental health problems in dementia carers. iSupport is undergoing global implementation, however there is an absence of effectiveness evidence. This study tested the effectiveness of iSupport to reduce distress and depression in dementia carers. Methods: A pragmatic randomised controlled trial was conducted in three centres. Adult carers (18+) living in the community were recruited in England, Wales and Scotland and randomly assigned (1:1) through a web-based system to iSupport or usual care. Outcome assessors were masked to allocation. The primary outcomes assessed the difference in distress and depression between baseline and six-months. The target sample size was 350 to enable 90% power, significance at 2.5% including 25% attrition (262 completers) on either outcome. Analysis followed the intention-to-treat (ITT) principle. The trial was registered with ISRCTN registry (17420703). Findings: Between 12th November 2021 and 31st March 2023,177 carers (50.3%) were randomised to usual care and 175 (49.7%) to iSupport. 263 (74.7%) completed the trial. All were included in the ITT analysis. Mean distress scores at six-months were 20.0 (SD = 8.3) for usual care and 20.6 (SD = 8.6) for iSupport. The mean difference was 0.16 (95% CI −1.17 to 1.49, p = 0.29) after adjusting for covariates. Mean depression scores at six-months were 9.5 (SD = 7.0) for usual care and 9.8 (SD = 6.5) for iSupport. The mean difference at six-months was −0.54 (95% CI = −1.70 to 0.62, p = 0.44). No serious adverse events were linked to the trial. Interpretation: To our knowledge this is the largest trial evaluating a self-guided online intervention in UK dementia carers, and the first to successfully evaluate the effectiveness of iSupport. The null findings are significant given the ongoing global implementation of iSupport by the WHO and the adoption of self-guided interventions into mainstream care delivery as part of digital health transformations. Funding: NIHR.http://www.sciencedirect.com/science/article/pii/S266677622400293XDementiaInformal carersFamily carersRandomised controlled trialSelf-guided interventionsOnline interventions |
| spellingShingle | Gill Windle Greg Flynn Zoe Hoare Nia Goulden Rhiannon Tudor Edwards Bethany Anthony Patricia Masterson Algar Suman Kurana Aimee Spector Gwenllian Hughes Ryan Innes John Connaghan Danielle Proctor Fatene Abakar Ismail Kiara Jackson Kieren Egan Joshua Stott Evaluating the effects of the World Health Organization's online intervention ‘iSupport’ to reduce depression and distress in dementia carers: a multi-centre six-month randomised controlled trial in the UKResearch in context The Lancet Regional Health. Europe Dementia Informal carers Family carers Randomised controlled trial Self-guided interventions Online interventions |
| title | Evaluating the effects of the World Health Organization's online intervention ‘iSupport’ to reduce depression and distress in dementia carers: a multi-centre six-month randomised controlled trial in the UKResearch in context |
| title_full | Evaluating the effects of the World Health Organization's online intervention ‘iSupport’ to reduce depression and distress in dementia carers: a multi-centre six-month randomised controlled trial in the UKResearch in context |
| title_fullStr | Evaluating the effects of the World Health Organization's online intervention ‘iSupport’ to reduce depression and distress in dementia carers: a multi-centre six-month randomised controlled trial in the UKResearch in context |
| title_full_unstemmed | Evaluating the effects of the World Health Organization's online intervention ‘iSupport’ to reduce depression and distress in dementia carers: a multi-centre six-month randomised controlled trial in the UKResearch in context |
| title_short | Evaluating the effects of the World Health Organization's online intervention ‘iSupport’ to reduce depression and distress in dementia carers: a multi-centre six-month randomised controlled trial in the UKResearch in context |
| title_sort | evaluating the effects of the world health organization s online intervention isupport to reduce depression and distress in dementia carers a multi centre six month randomised controlled trial in the ukresearch in context |
| topic | Dementia Informal carers Family carers Randomised controlled trial Self-guided interventions Online interventions |
| url | http://www.sciencedirect.com/science/article/pii/S266677622400293X |
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