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The effectiveness of a home care program for supporting caregivers of persons with dementia in developing countries: a randomised controlled trial from Goa, India
Dias A, Dewey ME, D'Souza J, Dhume R, Motghare DD, Shaji KS, Menon R, Prince M et al.. PloS one, 2008-06-04
Topic: Risk, prevention and care in population studies
Plain-language summary
Objectives To develop and evaluate the effectiveness of a home based intervention in reducing caregiver burden, promoting caregiver mental health and reducing behavioural problems in elderly persons with dementia. Methodology and principal findings This was a randomised controlled trial in which the person with dementia-caregiver dyad was randomly allocated either to receive the intervention immediately or to a waiting list group which received the intervention after 6 months. It was carried out in communities based in two talukas (administrative blocks) in Goa, India. Mild to moderate cases with dementia (diagnosed using the DSM IV criteria and graded using the Clinical Dementia Rating scale) and their caregivers were included in the trial. Community based intervention provided by a team consisting of Home Care Advisors who were supervised by a counselor and a psychiatrist, focusing on supporting the caregiver through information on dementia, guidance on behaviour management, a single psychiatric assessment and psychotropic medication if needed. We measured caregiver mental health (General Health Questionnaire), caregiver burden (Zarit Burden Score), distress due to behavioural disturbances (NPI-D), behavioural problems in the subject (NPI-S) and activities of daily living in the elder with dementia (EASI). Outcome evaluations were masked to the allocation status. We analysed each outcome with a mixed effects model. 81 families enrolled in the trial; 41 were randomly allocated to the intervention. 59 completed the trial and 18 died during the trial. The intervention led to a significant reduction of GHQ (-1.12, 95% CI -2.07 to -0.17) and NPI-D scores (-1.96, 95%CI -3.51 to -0.41) and non-significant reductions in the ZBS, EASI and NPI-S scores. We also observed a non-significant reduction in the total number of deaths in people with dementia in the intervention arm (OR 0.34, 95% CI 0.01 to 1.03). Conclusion Home based support for caregivers of persons with dementia, which emphasizes the use of locally available, low-cost human resources, is feasible, acceptable and leads to significant improvements in caregiver mental health and burden of caring. ClinicalTrials.gov NCT00479271.
What this study adds
Evidence grade: High
This is a trial. In a randomised trial of 81 families in Goa, India, home visits by locally recruited Home Care Advisors (supervised by a counselor and a psychiatrist) gave caregivers information on dementia, guidance on managing behaviour and, if needed, a psychiatric assessment and medication. Reported effect size: OR 0.34.
Taken from this record’s own fields, not from reading the paper. The grade is assigned from the abstract’s wording; what that means.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Dias, A., Dewey, M. E., D'Souza, J., Dhume, R., Motghare, D. D., Shaji, K. S., et al. (2008). The effectiveness of a home care program for supporting caregivers of persons with dementia in developing countries: a randomised controlled trial from Goa, India. PloS one. https://doi.org/10.1371/journal.pone.0002333
Vancouver
Dias A, Dewey ME, D'Souza J, Dhume R, Motghare DD, Shaji KS, et al. The effectiveness of a home care program for supporting caregivers of persons with dementia in developing countries: a randomised controlled trial from Goa, India. PloS one. 2008. doi:10.1371/journal.pone.0002333. PMID: 18523642.
BibTeX
@article{dias2008-18523642,
author = {Dias, A. and Dewey, M. E. and D'Souza, J. and Dhume, R. and Motghare, D. D. and Shaji, K. S. and Menon, R. and Prince, M. and others},
title = {{The effectiveness of a home care program for supporting caregivers of persons with dementia in developing countries: a randomised controlled trial from Goa, India}},
journal = {PloS one},
year = {2008},
doi = {10.1371/journal.pone.0002333},
pmid = {18523642},
url = {https://doi.org/10.1371/journal.pone.0002333}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
Key findings
- The intervention led to a significant reduction of GHQ (-1.12, 95% CI -2.07 to -0.17) and NPI-D scores (-1.96, 95%CI -3.51 to -0.41) and non-significant reductions in the ZBS, EASI and NPI-S scores.
- We also observed a non-significant reduction in the total number of deaths in people with dementia in the intervention arm (OR 0.34, 95% CI 0.01 to 1.03).
- Conclusion Home based support for caregivers of persons with dementia, which emphasizes the use of locally available, low-cost human resources, is feasible, acceptable and leads to significant improvements in caregiver mental health and burden of caring.
Why it matters
In a randomised trial of 81 families in Goa, India, home visits by locally recruited Home Care Advisors (supervised by a counselor and a psychiatrist) gave caregivers information on dementia, guidance on managing behaviour and, if needed, a psychiatric assessment and medication. Compared with families on a 6-month waiting list, caregivers had significantly better scores on a mental-health questionnaire (GHQ, −1.12) and less distress from behaviour problems (NPI-D, −1.96). Changes in caregiver burden, the person's behaviour and daily functioning, and deaths were not statistically significant, so the evidence supports caregiver well-being rather than outcomes for the person with dementia.
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Study details
- Study designrandomized controlled trial
- Effect sizeOR 0.34
- Evidence strengthHigh
How this study scored 71/100
Published in a peer-reviewed journal, and it is a randomized controlled trial. Scored zero for sample size because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (PloS one) |
| Journal's citation record | 4 / 4 | PLoS ONE: journal h-index 594 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomized controlled trial |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2008 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (pubmed indexes it as a clinical or observational study) |
| Randomized / blinded | 1 / 2 | Randomized (as stated in the record) |
| Times cited | 5 / 7 | Cited 270 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 13.5 citations a year over 20 year(s) since 2008 |
| Impact for its field and year | 3 / 6 | Cited 8.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 9 other studies in this library |
| Still being cited | 2 / 4 | Cited 33 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Vikram Patel: h-index 145 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | King's College London: institution h-index 1,348 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 18523642) |
| Free to read | 2 / 2 | Free to read |
| Total | 71 / 100 | — |
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