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Research evaluating the effectiveness of dementia interventions in low- and middle-income countries: A systematic mapping of 340 randomised controlled trials.
Salcher-Konrad, Maximilian; Shi, Cheng; Patel, Disha; McDaid, David; Astudillo-García, Claudia Iveth; Bobrow, Kirsten; Choy, Jacky; Comas-Herrera, Adelina; Fry, Andra; Knapp, Martin; Leung, Dara Kiu Yi; Lopez-Ortega, Mariana; Lorenz-Dant, Klara; Musyimi, Christine; Ndetei, David; Nguyen, Tuan Anh; Oliveira, Deborah; Putra, Aditya; Vara, Alisha; Wong, Gloria; Naci, Huseyin.
Afiliación
  • Salcher-Konrad M; Care Policy and Evaluation Centre (CPEC), Department of Health Policy, London School of Economics and Political Science, London, UK.
  • Shi C; WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Pharmacoeconomics Department, Austrian National Public Health Institute (Gesundheit Österreich GmbH/GÖG), Vienna, Austria.
  • Patel D; School of Graduate Studies (GS) & Institute of Policy Studies (IPS), Lingnan University, Hong Kong, Hong Kong.
  • McDaid D; Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong.
  • Astudillo-García CI; Center for Social Welfare Studies, Beijing Normal University, Beijing, China.
  • Bobrow K; Care Policy and Evaluation Centre (CPEC), Department of Health Policy, London School of Economics and Political Science, London, UK.
  • Choy J; Care Policy and Evaluation Centre (CPEC), Department of Health Policy, London School of Economics and Political Science, London, UK.
  • Comas-Herrera A; Epidemiological and Psychosocial Research Directorate, National Institute of Psychiatry Ramon de la Fuente Muñiz, Mexico City, Mexico.
  • Fry A; Division of Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
  • Knapp M; The Global Brain Health Institute, The University of California at San Francisco, San Francisco, California, USA.
  • Leung DKY; Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong.
  • Lopez-Ortega M; Care Policy and Evaluation Centre (CPEC), Department of Health Policy, London School of Economics and Political Science, London, UK.
  • Lorenz-Dant K; Library, London School of Economics and Political Science, London, UK.
  • Musyimi C; Care Policy and Evaluation Centre (CPEC), Department of Health Policy, London School of Economics and Political Science, London, UK.
  • Ndetei D; Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong.
  • Nguyen TA; National Institute of Geriatrics, National Institutes of Health, Mexico City, Mexico.
  • Oliveira D; Care Policy and Evaluation Centre (CPEC), Department of Health Policy, London School of Economics and Political Science, London, UK.
  • Putra A; Africa Mental Health Research and Training Foundation, Nairobi, Kenya.
  • Vara A; Africa Mental Health Research and Training Foundation, Nairobi, Kenya.
  • Wong G; University of Nairobi, Nairobi, Kenya.
  • Naci H; World Psychiatric Association Collaborating Centre for Research and Training, AMHRTF, Nairobi, Kenya.
Int J Geriatr Psychiatry ; 38(7): e5965, 2023 07.
Article en En | MEDLINE | ID: mdl-37430439
OBJECTIVES: More people with dementia live in low- and middle-income countries (LMICs) than in high-income countries, but best-practice care recommendations are often based on studies from high-income countries. We aimed to map the available evidence on dementia interventions in LMICs. METHODS: We systematically mapped available evidence on interventions that aimed to improve the lives of people with dementia or mild cognitive impairment (MCI) and/or their carers in LMICs (registered on PROSPERO: CRD42018106206). We included randomised controlled trials (RCTs) published between 2008 and 2018. We searched 11 electronic academic and grey literature databases (MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Global Health, World Health Organization Global Index Medicus, Virtual Health Library, Cochrane CENTRAL, Social Care Online, BASE, MODEM Toolkit) and examined the number and characteristics of RCTs according to intervention type. We used the Cochrane risk of bias 2.0 tool to assess the risk of bias. RESULTS: We included 340 RCTs with 29,882 (median, 68) participants, published 2008-2018. Over two-thirds of the studies were conducted in China (n = 237, 69.7%). Ten LMICs accounted for 95.9% of included RCTs. The largest category of interventions was Traditional Chinese Medicine (n = 149, 43.8%), followed by Western medicine pharmaceuticals (n = 109, 32.1%), supplements (n = 43, 12.6%), and structured therapeutic psychosocial interventions (n = 37, 10.9%). Overall risk of bias was judged to be high for 201 RCTs (59.1%), moderate for 136 (40.0%), and low for 3 (0.9%). CONCLUSIONS: Evidence-generation on interventions for people with dementia or MCI and/or their carers in LMICs is concentrated in just a few countries, with no RCTs reported in the vast majority of LMICs. The body of evidence is skewed towards selected interventions and overall subject to high risk of bias. There is a need for a more coordinated approach to robust evidence-generation for LMICs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Demencia / Disfunción Cognitiva Tipo de estudio: Clinical_trials / Guideline / Systematic_reviews Límite: Humans País/Región como asunto: Asia Idioma: En Revista: Int J Geriatr Psychiatry Asunto de la revista: GERIATRIA / PSIQUIATRIA Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Demencia / Disfunción Cognitiva Tipo de estudio: Clinical_trials / Guideline / Systematic_reviews Límite: Humans País/Región como asunto: Asia Idioma: En Revista: Int J Geriatr Psychiatry Asunto de la revista: GERIATRIA / PSIQUIATRIA Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido