Effects of a virtual iSupport Program on carers and people with dementia

Abstract

Introduction: We conducted a virtual iSupport Program intervention for carers of people living with dementia (PLWD).

Methods: We applied a pragmatic randomized controlled trial to evaluate a multicomponent program delivered virtually in four organizations (July 2022 to December 2024). The primary outcome was quality of life (QoL) of carers and PLWD at 12 months post-baseline, and the secondary outcomes were carers' self-efficacy, social support, reactions to behavior, PLWD's behavior frequency, hospital admissions, and emergency department presentations.

Results: One hundred forty-nine carers enrolled in the study. The intervention group reported increased mental-health-related QoL points of 12.0 (p < 0.001), self-efficacy points of 14.8 to 18.5 (p < 0.001), social support points of 0.25 (p < 0.028), reduced reactions to behavior points of -0.25 (p < 0.028), and a 60% lower hospital admission rate (p = 0.045) at 12 months compared with the usual care group.

Discussion: The virtual iSupport Program showed benefits for both carers and PLWD in a 12-month intervention.

Trial registration: Australia New Zealand Clinical Trials Registry: ACTRN12622000199718.

Highlights: A total of 149 dementia carers participated in the virtual iSupport program intervention trial. The program included skills training, peer support, and access to care services. The program improved mental health-related quality of life for carers. The program improved self-efficacy, social support, and reduced distress for carers. The program reduced 60% hospital admission rate for people with dementia.

Keywords: behavioral problem; dementia; family caregivers; health services for the aged; home care services; online social support; quality of life; self‐efficacy.

FIGURE 1

A conceptual model of change. ADL, acitivites of daily living; ED, emergency department; iADL, instrumental activities of daily living; PLWD, people living with dementia; PWD, people with dementia; QoL, quality of life.

FIGURE 2

Flow chart of the virtual iSupport Program.

FIGURE 3

(A) A multivariate mixed effect linear regression model to estimate the intervention effects on the primary and secondary outcomes. All models are adjusted for gender, age, relationship with the care recipients, marital status, duration in care role, live in the same household with PWD or not, religion, employment status, education level, financial pressure, family members’ help and baseline outcome variables. (B) A mixed‐effect Poisson regression model to estimate the intervention effects on the hospital admission rate and the emergency department presentation rate at 6 months and 12 months using the IRR. All models are adjusted for gender, age, relationship with the care recipients, marital status, duration in care role, live in the same household with PWD or not, religion, employment status, education level, financial pressure, family members’ help and baseline outcome variables. CI, confidence interval; CSE = Caregiver self‐efficacy; IRR, incidence rate ratio; M = months; MCS, mental component score; PCS = physical component score; PLWD, people living with dementia; PWD = people with dementia; QoL = quality of life.