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BMJ. 2006 Apr 1;332(7544):756-61. Epub 2006 Mar 16.

Effect of enhanced psychosocial care on antipsychotic use in nursing home residents with severe dementia: cluster randomised trial.

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  • 1Oxford University and Oxford Mental Healthcare Trust, Oxford.

Erratum in

  • BMJ. 2006 Apr 1;332(7544):61.

Abstract

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.

PMID:
16543297
PMCID:
PMC1420717
DOI:
10.1136/bmj.38782.575868.7C
[PubMed - indexed for MEDLINE]
Free PMC Article
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