Orforglipron for obesity treatment in older patients ≥65 years with or without type 2 diabetes: A post hoc subgroup analysis of the ATTAIN-1 and ATTAIN-2 trials.

A 2023 systematic review of Acceptance and Commitment Therapy (ACT) for unpaid carers of people with long-term conditions identified ten studies in family carers of people with dementia, including seven single-arm feasibility studies. Three randomised controlled trials (RCTs) evaluated individual ACT delivered in person or via video call by trained therapists compared with active controls or brief psychoeducation, reporting effect sizes (SMD) of 0.35–0.64 for anxiety symptoms, but with small sample sizes (n = 19–66). We updated the search (MEDLINE, PsycInfo, CINAHL; inception to December 20 2025) using the terms “acceptance and commitment therapy”, “dementia”, and “carer∗”/“caregiver∗”, identifying seven additional studies: one single case study, three single-arm feasibility studies, and three small RCTs (n = 33, 64, 92) of one-to-one ACT delivered by trained therapists via telephone or video call versus standard care or brief psychoeducation. To date, no adequately powered RCT has evaluated ACT for family carers of people with dementia, regardless of delivery format, and no RCTs have examined self-help ACT, which does not require highly qualified therapists. We conducted the first adequately powered, multicentre RCT (n = 496) evaluating the effectiveness of internet-delivered self-help ACT (iACT4CARERS) for reducing anxiety in family carers of people with dementia, guided by non-expert therapists, plus treatment-as-usual versus treatment-as-usual alone. The intervention tested a minimally therapist-supported, fully remote delivery model across England to maximise scalability and accessibility. After adjustment for baseline anxiety score, ethnicity, and education, iACT4CARERS plus treatment-as-usual significantly reduced anxiety (primary outcome) compared with treatment-as-usual alone at 12- and 24-weeks post-randomisation. Similar benefits were observed for all secondary outcomes, including depressive symptoms, psychological flexibility, and experiential avoidance in caregiving. No serious adverse events were reported, supporting the safety of the intervention.