OBJECTIVE: To evaluate the effectiveness of a training and support intervention for nursing home staff in reducing the proportion of residents with dementia who are prescribed neuroleptics. DESIGN: Cluster randomised controlled trial with blinded assessment of outcome. SETTING: 12 specialist nursing homes for people with dementia in London, Newcastle, and Oxford. PARTICIPANTS: Residents of the 12 nursing homes; numbers varied during the study period. INTERVENTION: Training and support intervention delivered to nursing home staff over 10 months, focusing on alternatives to drugs for the management of agitated behaviour in dementia. MAIN OUTCOME MEASURES: Proportion of residents in each home who were prescribed neuroleptics and mean levels of agitated and disruptive behaviour (Cohen-Mansfield agitation inventory) in each home at 12 months. RESULTS: At 12 months the proportion of residents taking neuroleptics in the intervention homes (23.0%) was significantly lower than that in the control homes (42.1%): average reduction in neuroleptic use 19.1% (95% confidence interval 0.5% to 37.7%). No significant differences were found in the levels of agitated or disruptive behaviour between intervention and control homes. CONCLUSIONS: Promotion of person centred care and good practice in the management of patients with dementia with behavioural symptoms provides an effective alternative to neuroleptics.
RCT Entities:
OBJECTIVE: To evaluate the effectiveness of a training and support intervention for nursing home staff in reducing the proportion of residents with dementia who are prescribed neuroleptics. DESIGN: Cluster randomised controlled trial with blinded assessment of outcome. SETTING: 12 specialist nursing homes for people with dementia in London, Newcastle, and Oxford. PARTICIPANTS: Residents of the 12 nursing homes; numbers varied during the study period. INTERVENTION: Training and support intervention delivered to nursing home staff over 10 months, focusing on alternatives to drugs for the management of agitated behaviour in dementia. MAIN OUTCOME MEASURES: Proportion of residents in each home who were prescribed neuroleptics and mean levels of agitated and disruptive behaviour (Cohen-Mansfield agitation inventory) in each home at 12 months. RESULTS: At 12 months the proportion of residents taking neuroleptics in the intervention homes (23.0%) was significantly lower than that in the control homes (42.1%): average reduction in neuroleptic use 19.1% (95% confidence interval 0.5% to 37.7%). No significant differences were found in the levels of agitated or disruptive behaviour between intervention and control homes. CONCLUSIONS: Promotion of person centred care and good practice in the management of patients with dementia with behavioural symptoms provides an effective alternative to neuroleptics.
Authors: P P De Deyn; K Rabheru; A Rasmussen; J P Bocksberger; P L Dautzenberg; S Eriksson; B A Lawlor Journal: Neurology Date: 1999-09-22 Impact factor: 9.910
Authors: M Margallo-Lana; A Swann; J O'Brien; A Fairbairn; K Reichelt; D Potkins; P Mynt; C Ballard Journal: Int J Geriatr Psychiatry Date: 2001-01 Impact factor: 3.485
Authors: C Ballard; J O'Brien; I James; P Mynt; M Lana; D Potkins; K Reichelt; L Lee; A Swann; J Fossey Journal: Int Psychogeriatr Date: 2001-03 Impact factor: 3.878
Authors: J S Street; W S Clark; K S Gannon; J L Cummings; F P Bymaster; R N Tamura; S J Mitan; D L Kadam; T M Sanger; P D Feldman; G D Tollefson; A Breier Journal: Arch Gen Psychiatry Date: 2000-10
Authors: Anna-Liisa Juola; Mikko P Bjorkman; Sarita Pylkkanen; Harriet Finne-Soveri; Helena Soini; Hannu Kautiainen; J Simon Bell; Kaisu H Pitkala Journal: Drugs Aging Date: 2015-11 Impact factor: 3.923
Authors: Maud J L Graff; Myrra J M Vernooij-Dassen; Marjolein Thijssen; Joost Dekker; Willibrord H L Hoefnagels; Marcel G M Olde Rikkert Journal: BMJ Date: 2006-11-17
Authors: Laura N Gitlin; Laraine Winter; Tracey Vause Earland; E Adel Herge; Nancy L Chernett; Catherine V Piersol; Janice P Burke Journal: Gerontologist Date: 2009-05-06
Authors: Joseph T Hanlon; Xinhua Zhao; Jennifer G Naples; Sherrie L Aspinall; Subashan Perera; David A Nace; Nicholas G Castle; Susan L Greenspan; Carolyn T Thorpe Journal: J Am Geriatr Soc Date: 2017-02-02 Impact factor: 5.562