Evidence map›Paper›PMID 40379340›Full record

Trial reportBMJ open2025

Cost-consequence analysis of an e-health intervention to reduce distress in dementia carers: results from the iSupport randomised controlled trial.

Bethany Anthony, Kodchawan Doungsong, Catherine MacLeod, Greg Flynn, Patricia Masterson-Algar, Nia Goulden, Kieren Egan, Kiara Jackson, Suman Kurana, Gwenllian Hughes and 9 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Bethany AnthonyCentre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Bangor, UK b.anthony@bangor.ac.uk.ORCID http://orcid.org/0000-0002-2593-1069
Kodchawan DoungsongCentre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Bangor, UK.
Catherine MacLeodCentre for Population Health Sciences, Usher Institute, The University of Edinburgh, Edinburgh, UK.
Greg FlynnNorth Wales Organisation for Randomised Trials in Health and Social Care (NWORTH), Bangor University, Bangor, UK.
Patricia Masterson-AlgarDementia Services Development Centre Wales (DSDC Wales), Bangor University, Bangor, UK.ORCID http://orcid.org/0000-0001-6344-1346
Nia GouldenNorth Wales Organisation for Randomised Trials in Health and Social Care (NWORTH), Bangor University, Bangor, UK.ORCID http://orcid.org/0000-0001-6511-3987
Kieren EganDepartment of Computer and Information Science, University of Strathclyde, Glasgow, UK.ORCID http://orcid.org/0000-0002-1639-4281
Kiara JacksonDementia Services Development Centre Wales (DSDC Wales), Bangor University, Bangor, UK.
Suman KuranaDepartment of Clinical, Educational and Health Psychology, University College London, London, UK.
Gwenllian HughesDementia Services Development Centre Wales (DSDC Wales), Bangor University, Bangor, UK.
Ryan InnesDepartment of Computer and Information Science, University of Strathclyde, Glasgow, UK.
John ConnaghanDepartment of Computer and Information Science, University of Strathclyde, Glasgow, UK.
Danielle ProctorDepartment of Clinical, Educational and Health Psychology, University College London, London, UK.
Fatene Abakar IsmailDepartment of Computer and Information Science, University of Strathclyde, Glasgow, UK.
Zoe HoareNorth Wales Organisation for Randomised Trials in Health and Social Care (NWORTH), Bangor University, Bangor, UK.ORCID http://orcid.org/0000-0003-1803-5482
Aimee SpectorDepartment of Clinical, Educational and Health Psychology, University College London, London, UK.ORCID http://orcid.org/0000-0003-4448-8143
Joshua StottDepartment of Clinical, Educational and Health Psychology, University College London, London, UK.
Gill WindleDementia Services Development Centre Wales (DSDC Wales), Bangor University, Bangor, UK.ORCID http://orcid.org/0000-0003-0479-1172
Rhiannon Tudor EdwardsCentre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Bangor, UK.ORCID http://orcid.org/0000-0003-4748-5730

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe use of e-health interventions has grown in demand due to their accessibility, low implementation costs and their potential to improve the health and well-being of people across a large geographical area. Despite these potential benefits, little is known about the cost-effectiveness of self-guided e-health interventions. The aim of the study was to compare the cost and consequences of 'iSupport', an e-health intervention to reduce mental health issues in dementia carers.

designA cost-consequence analysis (CCA) of a multi-centre, single-blind randomised controlled trial of iSupport. The CCA was conducted from a public sector (National Health Service, social care and local authority) perspective plus a wider societal perspective. Delivery costs of iSupport were collected using a bottom-up micro-costing approach.

setting352 participants were recruited from three centres in England, Wales and Scotland.

participantsParticipants eligible for inclusion were adults over the age of 18 years who self-identified as an unpaid carer with at least 6 months of experience caring for an individual with a diagnosis of dementia. Between 12 November 2021 and 31 March 2023, 2332 carers were invited to take part in the study. 352 participants were randomised: 175 randomised to the iSupport intervention group and 177 to the usual care control group. The mean age of participants in the intervention and control groups was 63 and 62, respectively.

main outcome measuresThe CCA presented the disaggregated costs and health-related quality of life measured using the EuroQol five-dimension.

resultsThere was no significant difference in generic health-related quality of life measured using the EQ-5D-5L (p=0.67). Both groups reported higher mean costs between baseline and 6 months, but the change in costs was significantly lower in the intervention group. Between baseline and 6 months, the mean change in total resource use costs from the public sector perspective was significantly different between groups (p=0.003, r=-0.161) reporting a mean change per participant of £146 (95% CI: -33 to 342) between the intervention and control groups. From the wider societal perspective, there was no significant difference (p=0.23) in the mean change in total resource use and informal care costs between the two groups from baseline to 6 months.

conclusionUse of iSupport was associated with reduced health and social care resource use costs for carers compared with care-as-usual. Self-guided e-health interventions for dementia carers may have the potential to reduce health and social care resource use and wider societal costs, but evidence relating to their effectiveness and cost-effectiveness is lacking. TRIAL REGISTRATION NUMBER: ISRCTN17420703.

Indexed as

CaregiversDementiaStress, PsychologicalTelemedicineAdultAgedCost-Benefit AnalysisFemaleHumansMaleMiddle AgedQuality of LifeSingle-Blind MethodCaregiversDementiaHealth Care CostsHEALTH ECONOMICS

Identifiers

PMID40379340
PMCPMC12086930

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.