Evidence map›Paper›PMID 31357949›Full record

Trial reportBMC geriatrics2019

A pragmatic randomised controlled trial (RCT) and realist evaluation of the interdisciplinary home-bAsed Reablement program (I-HARP) for improving functional independence of community dwelling older people with dementia: an effectiveness-implementation hybrid design.

Yun-Hee Jeon, Judy M Simpson, Lee-Fay Low, Robert Woods, Richard Norman, Loren Mowszowski, Lindy Clemson, Sharon L Naismith, Henry Brodaty, Sarah Hilmer and 3 more

Abstract readMulticenter StudyPragmatic Clinical TrialRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC geriatrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 3 pooled it
–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

17 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Pooled it
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  11. Rehabilitation Services for Young-Onset Dementia: Examples from High- and Low-Middle-Income Countries.International journal of environmental research and public health · 2024
    Review
  12. Article
  13. Article
  14. Publication Trends in Reablement - A Scoping Review.Journal of multidisciplinary healthcare · 2023
    Article
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  17. Article
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

13 authors.

Yun-Hee JeonSusan Wakil School of Nursing and Midwifery, The University of Sydney, 88 Mallett Street - Building M02, Camperdown, Sydney, NSW, Australia. yun-hee.jeon@sydney.edu.au.ORCID 0000-0003-2031-9134
Judy M SimpsonSydney School of Public Health, The University of Sydney, Camperdown, Australia.
Lee-Fay LowFaculty of Health Sciences, The University of Sydney, Sydney, Australia.
Robert WoodsBangor University, Bangor, UK.
Richard NormanCurtin University, Perth, Australia.
Loren MowszowskiBrain and Mind Centre and School of Psychology, The University of Sydney, Sydney, Australia.
Lindy ClemsonFaculty of Health Sciences, The University of Sydney, Sydney, Australia.
Sharon L NaismithBrain and Mind Centre, Charles Perkins Centre and School of Psychology, The University of Sydney, Sydney, Australia.
Henry BrodatyCHeBA (Centre for Healthy Brain Ageing), School of Psychiatry, UNSW, Sydney, Australia.
Sarah HilmerKolling Institute, Northern Clinical School, Faculty of Medicine and Health, University of Sydney and Royal North Shore Hospital, St Leonards, NSW, Australia.
Amanda Miller AmberberCharles Sturt University, Albury Wodonga, Australia.
Laura N GitlinCollege of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA.
Sarah SzantonJohns Hopkins School of Nursing, Johns Hopkins School of Public Health, Baltimore, MD, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA major gap exists internationally in providing support to maintain functional and social independence of older people with dementia living at home. This project evaluates a model of care that integrates evidence-based strategies into a person-centred interdisciplinary rehabilitation package: Interdisciplinary Home-bAsed Reablement Program (I-HARP). Two central aims are: 1) to determine the effectiveness of I-HARP on functional independence, mobility, quality of life and depression among people with dementia, their home environmental safety, carer burden and quality of life, and I-HARP cost-effectiveness; and 2) to evaluate the processes, outcomes and influencing factors of the I-HARP implementation.

methodsI-HARP is a 4-month model of care, integrated in community aged care services and hospital-based community geriatric services, and consists of: 1) 8-12 home visits, tailored to the individual client's needs, by an occupational therapist, registered nurse, and other allied health staff; 2) minor home modifications/assistive devices to the value of <A$1000 per participant; and 3) three individual carer support sessions. The overarching design is a mixed-methods action research approach, consisting of a multi-centre pragmatic parallel-arm randomised controlled trial (RCT) and realist evaluation, conducted in two phases. Participants include 176 dyads (person aged > 60 years with mild to moderate dementia and his/her carer). During Phase I, I-HARP advisory group is established and training of I-HARP interventionists is completed, and the effectiveness of I-HARP is examined using a pragmatic RCT. Phase II, conducted concurrently with Phase I, focuses on the process evaluation of the I-HARP implementation using a realist approach. Semi-structured interviews with participants and focus groups with I-HARP interventionists and participating site managers will provide insights into the contexts, mechanisms and outcomes of I-HARP. DISCUSSION: I-HARP is being evaluated within the real-world systems of hospital-based and community-based aged care services in Australia. Future directions and strategies for reablement approaches to care for community dwelling people living with dementia, will be developed. The study will provide evidence to inform key stakeholders in their decision making and the use/delivery of the program, as well as influence future systems-thinking and changes for dementia care.

trial registrationAustralian New Zealand Clinical Trial Registry ACTR N12618000600246 (approved 18/04/2018).

Indexed as

AgedAged, 80 and overAustraliaCaregiversDementiaDepressionFemaleHome Care ServicesHumansIndependent LivingMaleMiddle AgedQuality of LifeTreatment OutcomeCognitive rehabilitationCommunity careDementiaImplementationInterdisciplinary teamworkPragmatic trialReablement

Identifiers

PMID31357949
PMCPMC6664757

What OpenQuestion holds

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LicenceCC BY
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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 OpenQuestion graph.