Britt Appelhof1, Christian Bakker2, Marjolein E de Vugt3, Jeannette C L van Duinen-van den IJssel4, Sandra A Zwijsen5, Martin Smalbrugge5, Steven Teerenstra6, Frans R J Verhey3, Sytse U Zuidema7, Raymond T C M Koopmans8. 1. Department of Primary and Community Care (BA, CB, JCLD, RTCMK), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands; Knowledge Center for Specialized Care (BA), Landrijt Archipel, Eindhoven, The Netherlands; Radboudumc Alzheimer Center (BA, CB, JCLD, RTCMK), Nijmegen, The Netherlands; Send correspondence and reprint requests to Britt Appelhof, M.Sc., Department of Primary and Community Care, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.. Electronic address: britt.appelhof@radboudumc.nl. 2. Department of Primary and Community Care (BA, CB, JCLD, RTCMK), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands; Radboudumc Alzheimer Center (BA, CB, JCLD, RTCMK), Nijmegen, The Netherlands; Center for Specialized Care in Young-Onset Dementia (CB), Florence Mariahoeve, The Hague. 3. Alzheimer Center Limburg (MEV, FRJV), School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands. 4. Department of Primary and Community Care (BA, CB, JCLD, RTCMK), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands; Radboudumc Alzheimer Center (BA, CB, JCLD, RTCMK), Nijmegen, The Netherlands. 5. Department of General Practice and Elderly Care Medicine/Amsterdam Public Health Research Institute (SAZ, MS), VU University Medical Center, Amsterdam. 6. Department of Health Evidence (ST), Section Biostatistics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands. 7. Department of General Practice and Elderly Care Medicine (SUZ), University Medical Center Groningen, Groningen, The Netherlands. 8. Department of Primary and Community Care (BA, CB, JCLD, RTCMK), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands; Radboudumc Alzheimer Center (BA, CB, JCLD, RTCMK), Nijmegen, The Netherlands; De Waalboog "Joachim en Anna" Center for Specialized Geriatric Care (RTCMK), Nijmegen, The Netherlands.
Abstract
OBJECTIVE: The effect of an intervention on neuropsychiatric symptoms (NPS), particularly agitation and aggression, and psychotropic drug use (PDU) in institutionalized people with young-onset dementia (YOD) was evaluated. METHODS: A randomized controlled trial was conducted using a stepped wedge design. Thirteen YOD special care units were randomly assigned to three groups, which received the intervention at different time points. Four assessments took place every 6 months during a period of 18 months. Two hundred seventy-four people with YOD who resided in YOD special care units participated, of whom 131 took part in all assessments. The intervention consisted of an educational program combined with a care program, which structured the multidisciplinary process of managing NPS. The care program included the following five steps: evaluation of psychotropic drug prescription, detection, analysis, treatment, and evaluation of treatment of NPS. The Cohen-Mansfield Agitation Inventory and the Neuropsychiatric Inventory-Nursing Home version were used to assess NPS. Data on PDU were retrieved from residents' medical files. Multilevel models were used to evaluate the effect of the intervention, which accounted for clustering of measurements in clients within units. RESULTS: No significant differences were found in agitation, aggression, other NPS, or PDU after crossing over to the intervention condition. CONCLUSION: We found no evidence that the intervention for management of NPS in nursing home residents with YOD was more effective in reducing agitation, aggression, other NPS, or PDU compared with care as usual.
RCT Entities:
OBJECTIVE: The effect of an intervention on neuropsychiatric symptoms (NPS), particularly agitation and aggression, and psychotropic drug use (PDU) in institutionalized people with young-onset dementia (YOD) was evaluated. METHODS: A randomized controlled trial was conducted using a stepped wedge design. Thirteen YOD special care units were randomly assigned to three groups, which received the intervention at different time points. Four assessments took place every 6 months during a period of 18 months. Two hundred seventy-four people with YOD who resided in YOD special care units participated, of whom 131 took part in all assessments. The intervention consisted of an educational program combined with a care program, which structured the multidisciplinary process of managing NPS. The care program included the following five steps: evaluation of psychotropic drug prescription, detection, analysis, treatment, and evaluation of treatment of NPS. The Cohen-Mansfield Agitation Inventory and the Neuropsychiatric Inventory-Nursing Home version were used to assess NPS. Data on PDU were retrieved from residents' medical files. Multilevel models were used to evaluate the effect of the intervention, which accounted for clustering of measurements in clients within units. RESULTS: No significant differences were found in agitation, aggression, other NPS, or PDU after crossing over to the intervention condition. CONCLUSION: We found no evidence that the intervention for management of NPS in nursing home residents with YOD was more effective in reducing agitation, aggression, other NPS, or PDU compared with care as usual.
Authors: Dennis van de Veen; Christian Bakker; Kirsten Peetoom; Yolande Pijnenburg; Janne M Papma; Marjolein de Vugt; Raymond Koopmans Journal: J Alzheimers Dis Date: 2021 Impact factor: 4.472
Authors: Jeannette C L van Duinen-van den IJssel; Christian Bakker; Martin Smalbrugge; Sandra A Zwijsen; Eddy Adang; Britt Appelhof; Sytse U Zuidema; Marjolein E de Vugt; Frans R J Verhey; Raymond T C M Koopmans Journal: Int J Geriatr Psychiatry Date: 2019-11-07 Impact factor: 3.485