TY - JOUR
T1 - Effect of person-centred care on antipsychotic drug use in nursing homes (EPCentCare): Study protocol for a cluster-randomised controlled trial
AU - Richter, Christin
AU - Berg, Almuth
AU - Fleischer, Steffen
AU - Köpke, Sascha
AU - Balzer, Katrin
AU - Fick, Eva Maria
AU - Sönnichsen, Andreas
AU - Löscher, Susanne
AU - Vollmar, Horst Christian
AU - Haastert, Burkhard
AU - Icks, Andrea
AU - Dintsios, Charalabos Markos
AU - Mann, Eva
AU - Wolf, Ursula
AU - Meyer, Gabriele
N1 - Publisher Copyright:
© Richter et al.
PY - 2015/6/4
Y1 - 2015/6/4
N2 - Background: The majority of nursing home residents with dementia experience behavioural and psychological symptoms like apathy, agitation, and anxiety. According to analyses of prescription prevalence in Germany, antipsychotic drugs are regularly prescribed as first-line treatment of neuropsychiatric symptoms in persons with dementia, although guidelines clearly prioritise non-pharmacological interventions. Frequently, antipsychotic drugs are prescribed for inappropriate reasons and for too long without regular reviewing. The use of antipsychotics is associated with adverse events like increased risk of falling, stroke, and mortality. The aim of the study is to investigate whether a person-centred care approach, successfully evaluated in nursing homes in the United Kingdom, can be implemented in German nursing homes and, in comparison with a control group, can result in a clinically relevant reduction of the proportion of residents with antipsychotic prescriptions. Methods/design: The study is a cluster-randomised controlled trial comparing an intervention group (two-day initial training on person-centred care and ongoing training and support programme) with a control group. Both study groups will receive, as optimised usual care, a medication review by an experienced psychiatrist/geriatrician providing feedback to the prescribing physician. Overall, 36 nursing homes in East, North, and West Germany will be randomised. The primary outcome is the proportion of residents receiving at least one antipsychotic prescription (long-term medication) after 12 months of follow-up. Secondary outcomes are residents' quality of life, agitated behaviour, as well as safety parameters like falls and fall-related medical attention. A health economic evaluation and a process evaluation will be performed alongside the study. Discussion: To improve care, a reduction of the current high prescription rate of antipsychotics in nursing homes by the intervention programme is expected.
AB - Background: The majority of nursing home residents with dementia experience behavioural and psychological symptoms like apathy, agitation, and anxiety. According to analyses of prescription prevalence in Germany, antipsychotic drugs are regularly prescribed as first-line treatment of neuropsychiatric symptoms in persons with dementia, although guidelines clearly prioritise non-pharmacological interventions. Frequently, antipsychotic drugs are prescribed for inappropriate reasons and for too long without regular reviewing. The use of antipsychotics is associated with adverse events like increased risk of falling, stroke, and mortality. The aim of the study is to investigate whether a person-centred care approach, successfully evaluated in nursing homes in the United Kingdom, can be implemented in German nursing homes and, in comparison with a control group, can result in a clinically relevant reduction of the proportion of residents with antipsychotic prescriptions. Methods/design: The study is a cluster-randomised controlled trial comparing an intervention group (two-day initial training on person-centred care and ongoing training and support programme) with a control group. Both study groups will receive, as optimised usual care, a medication review by an experienced psychiatrist/geriatrician providing feedback to the prescribing physician. Overall, 36 nursing homes in East, North, and West Germany will be randomised. The primary outcome is the proportion of residents receiving at least one antipsychotic prescription (long-term medication) after 12 months of follow-up. Secondary outcomes are residents' quality of life, agitated behaviour, as well as safety parameters like falls and fall-related medical attention. A health economic evaluation and a process evaluation will be performed alongside the study. Discussion: To improve care, a reduction of the current high prescription rate of antipsychotics in nursing homes by the intervention programme is expected.
UR - http://www.scopus.com/inward/record.url?scp=84931096282&partnerID=8YFLogxK
U2 - 10.1186/s13012-015-0268-3
DO - 10.1186/s13012-015-0268-3
M3 - Journal articles
C2 - 26037324
AN - SCOPUS:84931096282
SN - 1748-5908
VL - 10
JO - Implementation Science
JF - Implementation Science
IS - 1
M1 - 82
ER -
