Evidence map›Paper›PMID 39824599›Full record

Trial reportJournal of neurology, neurosurgery, and psychiatry2025

Effectiveness of the Interdisciplinary Home-bAsed Reablement Programme (I-HARP) on improving functional independence of people living with dementia: a multicentre, pragmatic, randomised, open-label, controlled trial.

Yun-Hee Jeon, Judy Simpson, Judith Fethney, Luisa Krein, Mirim Shin, Lee-Fay Low, Robert T Woods, Loren Mowszowski, Sarah Hilmer, Sharon L Naismith and 7 more

Abstract readMulticenter StudyRandomized Controlled TrialPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of neurology, neurosurgery, and psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

5 citing papers in PubMed.

  1. Cognitive Reablement Using Digital Voice Assistants for People Living With Dementia or Mild Cognitive Impairment: A Co-Design Study.Health expectations : an international journal of public participation in health care and health policy · 2026
    Article
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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

17 authors.

Yun-Hee JeonSusan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia yun-hee.jeon@sydney.edu.au.ORCID http://orcid.org/0000-0003-2031-9134
Judy SimpsonSchool of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Judith FethneySusan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Luisa KreinSusan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Mirim ShinSusan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Lee-Fay LowSchool of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Robert T WoodsDSDC Wales, School of Health Sciences, Bangor University, Bangor, UK.
Loren MowszowskiBrain and Mind Centre and School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia.
Sarah HilmerKolling Institute and Faculty of Medicine and Health, Northern Sydney Local Health District and The University of Sydney, Sydney, New South Wales, Australia.
Sharon L NaismithBrain and Mind Centre and School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia.
Lindy ClemsonSchool of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Henry BrodatyCentre for Healthy Brain Ageing, School of Psychiatry, UNSW Sydney, Sydney, New South Wales, Australia.ORCID http://orcid.org/0000-0001-9487-6617
Vasi NaganathanConcord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Amanda Miller AmberberMacquarie University, Sydney, New South Wales, Australia.
Danelle KennyCentre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia.
Laura GitlinCollege of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA.
Sarah SzantonSchools of Nursing, Medicine and Public Health, Johns Hopkins University, Baltimore, Maryland, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe investigated the effectiveness of an Interdisciplinary Home-bAsed Reablement Programme (I-HARP) on improving functional independence, health and well-being of people with dementia, family carer outcomes and costs.

methodA multicentre pragmatic parallel-arm randomised controlled trial compared I-HARP to usual care in community-dwelling people with mild to moderate dementia and their family carers in Sydney, Australia (2018-2022). I-HARP is a 4-month, home-based, dementia rehabilitation model delivered by an interdisciplinary team. Assessments were conducted at baseline (time-1), 4-month (time-2) and 12-month (time-3) follow-up. The primary outcome measure was the client's functional independence using the Disability Assessment for Dementia (DAD) scale at time-2, based on intention-to-treat analyses.

resultOf 130 recruited client-carer dyads, 116 dyads (58/group) completed the trial. The I-HARP group were not significantly better in most outcome measures than usual care at both time-2 and time-3; with the only statistically significant difference being a reduction in home environment hazards at time-2. Post hoc subgroup analysis of 66 clients with mild dementia found significantly better functional independence in the intervention group compared with those in usual care: difference 8.99 on DAD (95% CI 1.21, 16.79) at time-2 and difference 12.16 (95% CI 1.93, 22.38) at time-3. Economic evaluation suggests potentially lower resource use in I-HARP compared with usual care, but the cost-effectiveness is uncertain.

conclusionPrimary outcomes were not met for a population of people with dementia, with severity ranging from mild to moderate and severe. The I-HARP model appeared to benefit functional independence of participants with mild dementia, with potential cost savings. TRIAL REGISTRATION NUMBER: ACTRN12618000600246.

Indexed as

DementiaHome Care ServicesActivities of Daily LivingAgedAged, 80 and overAustraliaCaregiversFemaleHumansIndependent LivingMaleMiddle AgedTreatment OutcomeDEMENTIAREHABILITATION

Identifiers

PMID39824599
PMCPMC12322460

What OpenQuestion holds

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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.