MEDREV (pharmacy-health psychology intervention in people living with dementia with behaviour that challenges): the feasibility of measuring clinical outcomes and costs of the intervention
Abstract Background People living with dementia in care homes frequently exhibit “behaviour that challenges”. Anti-psychotics are used to treat such behaviour, but are associated with significant morbidity. This study researched the feasibility of conducting a trial of a full clinical medication rev...
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| Format: | Article |
| Language: | English |
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BMC
2020-03-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-020-5014-0 |
| _version_ | 1811295204716576768 |
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| author | Ian D. Maidment Garry Barton Niyah Campbell Rachel Shaw Nichola Seare Chris Fox Steve Iliffe Emma Randle Andrea Hilton Graeme Brown Nigel Barnes Jane Wilcock Sarah Gillespie Sarah Damery |
| author_facet | Ian D. Maidment Garry Barton Niyah Campbell Rachel Shaw Nichola Seare Chris Fox Steve Iliffe Emma Randle Andrea Hilton Graeme Brown Nigel Barnes Jane Wilcock Sarah Gillespie Sarah Damery |
| author_sort | Ian D. Maidment |
| collection | DOAJ |
| description | Abstract Background People living with dementia in care homes frequently exhibit “behaviour that challenges”. Anti-psychotics are used to treat such behaviour, but are associated with significant morbidity. This study researched the feasibility of conducting a trial of a full clinical medication review for care home residents with behaviour that challenges, combined with staff training. This paper focusses on the feasibility of measuring clinical outcomes and intervention costs. Methods People living with moderate to severe dementia, receiving psychotropics for behaviour that challenges, in care homes were recruited for a medication review by a specialist pharmacist. Care home and primary care staff received training on the management of challenging behaviour. Data were collected at 8 weeks, and 3 and 6 months. Measures were Neuropsychiatric Inventory-Nursing Home version (NPI-NH), cognition (sMMSE), quality of life (EQ-5D-5 L/DEMQoL) and costs (Client Services Receipt Inventory). Response rates, for clinical, quality of life and health economic measures, including the levels of resource-use associated with the medication review and other non-intervention costs were calculated. Results Twenty-nine of 34 participants recruited received a medication review. It was feasible to measure the effects of the complex intervention on the management of behaviour that challenges with the NPI-NH. There was valid NPI-NH data at each time point (response rate = 100%). The sMMSE response rate was 18.2%. Levels of resource-use associated with the medication review were estimated for all 29 participants who received a medication review. Good response levels were achieved for other non-intervention costs (100% completion rate), and the EQ-5D-5 L and DEMQoL (≥88% at each of the time points where data was collected). Conclusions It is feasible to measure the clinical and cost effectiveness of a complex intervention for behaviour that challenges using the NPI-NH and quality of life measures. Trial registration ISRCTN58330068. Retrospectively registered, 15 October 2017. |
| first_indexed | 2024-04-13T05:29:57Z |
| format | Article |
| id | doaj.art-0ae74520838f436096a852a7c7a49c99 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-13T05:29:57Z |
| publishDate | 2020-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-0ae74520838f436096a852a7c7a49c992022-12-22T03:00:29ZengBMCBMC Health Services Research1472-69632020-03-012011910.1186/s12913-020-5014-0MEDREV (pharmacy-health psychology intervention in people living with dementia with behaviour that challenges): the feasibility of measuring clinical outcomes and costs of the interventionIan D. Maidment0Garry Barton1Niyah Campbell2Rachel Shaw3Nichola Seare4Chris Fox5Steve Iliffe6Emma Randle7Andrea Hilton8Graeme Brown9Nigel Barnes10Jane Wilcock11Sarah Gillespie12Sarah Damery13School of Life and Health Sciences, Aston UniversityNorwich Clinical Trials Unit, University of East AngliaSchool of Life and Health Sciences, Aston UniversitySchool of Life and Health Sciences, Aston UniversityAston Health Research Innovation Cluster, Aston UniversityNorwich Medical School, University of East AngliaResearch Department of Primary Care & Population Health, University College LondonBirmingham and Solihull Mental Health NHS Foundation Trust, Research and Innovation Department, The BarberryFaculty of Health Sciences, University of HullBirmingham and Solihull Mental Health NHS Foundation TrustBirmingham and Solihull Mental Health NHS Foundation TrustResearch Department of Primary Care & Population Health, University College LondonDepartment of Clinical Healthcare, Faculty of Health and Life Sciences, Oxford Brookes UniversityInstitute of Applied Health Research, College of Medical and Dental Sciences, University of BirminghamAbstract Background People living with dementia in care homes frequently exhibit “behaviour that challenges”. Anti-psychotics are used to treat such behaviour, but are associated with significant morbidity. This study researched the feasibility of conducting a trial of a full clinical medication review for care home residents with behaviour that challenges, combined with staff training. This paper focusses on the feasibility of measuring clinical outcomes and intervention costs. Methods People living with moderate to severe dementia, receiving psychotropics for behaviour that challenges, in care homes were recruited for a medication review by a specialist pharmacist. Care home and primary care staff received training on the management of challenging behaviour. Data were collected at 8 weeks, and 3 and 6 months. Measures were Neuropsychiatric Inventory-Nursing Home version (NPI-NH), cognition (sMMSE), quality of life (EQ-5D-5 L/DEMQoL) and costs (Client Services Receipt Inventory). Response rates, for clinical, quality of life and health economic measures, including the levels of resource-use associated with the medication review and other non-intervention costs were calculated. Results Twenty-nine of 34 participants recruited received a medication review. It was feasible to measure the effects of the complex intervention on the management of behaviour that challenges with the NPI-NH. There was valid NPI-NH data at each time point (response rate = 100%). The sMMSE response rate was 18.2%. Levels of resource-use associated with the medication review were estimated for all 29 participants who received a medication review. Good response levels were achieved for other non-intervention costs (100% completion rate), and the EQ-5D-5 L and DEMQoL (≥88% at each of the time points where data was collected). Conclusions It is feasible to measure the clinical and cost effectiveness of a complex intervention for behaviour that challenges using the NPI-NH and quality of life measures. Trial registration ISRCTN58330068. Retrospectively registered, 15 October 2017.http://link.springer.com/article/10.1186/s12913-020-5014-0DementiaFeasibility studyBehaviour that challengesPsychotropics |
| spellingShingle | Ian D. Maidment Garry Barton Niyah Campbell Rachel Shaw Nichola Seare Chris Fox Steve Iliffe Emma Randle Andrea Hilton Graeme Brown Nigel Barnes Jane Wilcock Sarah Gillespie Sarah Damery MEDREV (pharmacy-health psychology intervention in people living with dementia with behaviour that challenges): the feasibility of measuring clinical outcomes and costs of the intervention BMC Health Services Research Dementia Feasibility study Behaviour that challenges Psychotropics |
| title | MEDREV (pharmacy-health psychology intervention in people living with dementia with behaviour that challenges): the feasibility of measuring clinical outcomes and costs of the intervention |
| title_full | MEDREV (pharmacy-health psychology intervention in people living with dementia with behaviour that challenges): the feasibility of measuring clinical outcomes and costs of the intervention |
| title_fullStr | MEDREV (pharmacy-health psychology intervention in people living with dementia with behaviour that challenges): the feasibility of measuring clinical outcomes and costs of the intervention |
| title_full_unstemmed | MEDREV (pharmacy-health psychology intervention in people living with dementia with behaviour that challenges): the feasibility of measuring clinical outcomes and costs of the intervention |
| title_short | MEDREV (pharmacy-health psychology intervention in people living with dementia with behaviour that challenges): the feasibility of measuring clinical outcomes and costs of the intervention |
| title_sort | medrev pharmacy health psychology intervention in people living with dementia with behaviour that challenges the feasibility of measuring clinical outcomes and costs of the intervention |
| topic | Dementia Feasibility study Behaviour that challenges Psychotropics |
| url | http://link.springer.com/article/10.1186/s12913-020-5014-0 |
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