The short-term effect of a modified comprehensive geriatric assessment and regularly case conferencing on neuropsychiatric symptoms in nursing homes: a cluster randomized trial

Abstract Aims To investigate the short-term effect of implementing a modified comprehensive geriatric assessment and regularly case conferencing in nursing homes on neuropsychiatric symptoms. Background Neuropsychiatric symptoms are common and may persist over time in nursing home residents. Evidenc...

Full description

Bibliographic Details
Main Authors: Geir-Tore Stensvik, Anne-Sofie Helvik, Gørill Haugan, Aslak Steinsbekk, Øyvind Salvesen, Sigrid Nakrem
Format: Article
Language:English
Published: BMC 2022-04-01
Series:BMC Geriatrics
Subjects:
Online Access:https://doi.org/10.1186/s12877-022-02976-x
_version_ 1817990436380213248
author Geir-Tore Stensvik
Anne-Sofie Helvik
Gørill Haugan
Aslak Steinsbekk
Øyvind Salvesen
Sigrid Nakrem
author_facet Geir-Tore Stensvik
Anne-Sofie Helvik
Gørill Haugan
Aslak Steinsbekk
Øyvind Salvesen
Sigrid Nakrem
author_sort Geir-Tore Stensvik
collection DOAJ
description Abstract Aims To investigate the short-term effect of implementing a modified comprehensive geriatric assessment and regularly case conferencing in nursing homes on neuropsychiatric symptoms. Background Neuropsychiatric symptoms are common and may persist over time in nursing home residents. Evidence of effective interventions is scarce. Design A parallel cluster-randomised controlled trial. Methods The intervention was monthly standardised case conferencing in combination with a modified comprehensive geriatric assessment. The control group received care as usual. Main outcome measure. The total score on the short version of the Neuropsychiatric Inventory (NPI-Q, 12-items). Results A total of 309 residents at 34 long-term care wards in 17 nursing homes (unit of randomisation) were included. The intervention care units conducted on average two case conference-meetings (range 1–3), discussing a mean of 4.8 (range 1–8) residents. After 3 months, there were no difference of NPI-Q total score between the intervention (-0.4) and the control group (0.5) (estimated mean difference = -1.0, 95% CI -2.4 to 0.5, p = 0.19). There was a difference in favour of the intervention group on one of the secondary outcome measures, the apathy symptoms (-0.5 95% CI: -0.9 to -0.1, p = 0.03). Conclusion In this study there were no short-term effect of case conferencing and modified comprehensive geriatric assessments after three months on the total score on neuropsychiatric symptoms. The intervention group had less apathy at 3 months follow-up compared to those receiving care as usual. The findings suggest that a more comprehensive intervention is needed to improve the total Neuropsychiatric symptoms burden and complex symptoms. Trial registration Due to delays in the organisation, the study was registered after study start, i.e. retrospectively in Clinicaltrials.gov # NCT02790372 at  https://clinicaltrials.gov/ ; Date of clinical trial registration: 03/06/2016.
first_indexed 2024-04-14T00:59:00Z
format Article
id doaj.art-0d363f2fa6c24b52ab2cb7e5a7070a8f
institution Directory Open Access Journal
issn 1471-2318
language English
last_indexed 2024-04-14T00:59:00Z
publishDate 2022-04-01
publisher BMC
record_format Article
series BMC Geriatrics
spelling doaj.art-0d363f2fa6c24b52ab2cb7e5a7070a8f2022-12-22T02:21:28ZengBMCBMC Geriatrics1471-23182022-04-0122111110.1186/s12877-022-02976-xThe short-term effect of a modified comprehensive geriatric assessment and regularly case conferencing on neuropsychiatric symptoms in nursing homes: a cluster randomized trialGeir-Tore Stensvik0Anne-Sofie Helvik1Gørill Haugan2Aslak Steinsbekk3Øyvind Salvesen4Sigrid Nakrem5Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU)Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU)Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU)Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU)Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU)Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU)Abstract Aims To investigate the short-term effect of implementing a modified comprehensive geriatric assessment and regularly case conferencing in nursing homes on neuropsychiatric symptoms. Background Neuropsychiatric symptoms are common and may persist over time in nursing home residents. Evidence of effective interventions is scarce. Design A parallel cluster-randomised controlled trial. Methods The intervention was monthly standardised case conferencing in combination with a modified comprehensive geriatric assessment. The control group received care as usual. Main outcome measure. The total score on the short version of the Neuropsychiatric Inventory (NPI-Q, 12-items). Results A total of 309 residents at 34 long-term care wards in 17 nursing homes (unit of randomisation) were included. The intervention care units conducted on average two case conference-meetings (range 1–3), discussing a mean of 4.8 (range 1–8) residents. After 3 months, there were no difference of NPI-Q total score between the intervention (-0.4) and the control group (0.5) (estimated mean difference = -1.0, 95% CI -2.4 to 0.5, p = 0.19). There was a difference in favour of the intervention group on one of the secondary outcome measures, the apathy symptoms (-0.5 95% CI: -0.9 to -0.1, p = 0.03). Conclusion In this study there were no short-term effect of case conferencing and modified comprehensive geriatric assessments after three months on the total score on neuropsychiatric symptoms. The intervention group had less apathy at 3 months follow-up compared to those receiving care as usual. The findings suggest that a more comprehensive intervention is needed to improve the total Neuropsychiatric symptoms burden and complex symptoms. Trial registration Due to delays in the organisation, the study was registered after study start, i.e. retrospectively in Clinicaltrials.gov # NCT02790372 at  https://clinicaltrials.gov/ ; Date of clinical trial registration: 03/06/2016.https://doi.org/10.1186/s12877-022-02976-xBehavioural symptomsCase conferencingCluster RCTCognitive impairmentComprehensive geriatric assessmentDementia; Long term facilities
spellingShingle Geir-Tore Stensvik
Anne-Sofie Helvik
Gørill Haugan
Aslak Steinsbekk
Øyvind Salvesen
Sigrid Nakrem
The short-term effect of a modified comprehensive geriatric assessment and regularly case conferencing on neuropsychiatric symptoms in nursing homes: a cluster randomized trial
BMC Geriatrics
Behavioural symptoms
Case conferencing
Cluster RCT
Cognitive impairment
Comprehensive geriatric assessment
Dementia; Long term facilities
title The short-term effect of a modified comprehensive geriatric assessment and regularly case conferencing on neuropsychiatric symptoms in nursing homes: a cluster randomized trial
title_full The short-term effect of a modified comprehensive geriatric assessment and regularly case conferencing on neuropsychiatric symptoms in nursing homes: a cluster randomized trial
title_fullStr The short-term effect of a modified comprehensive geriatric assessment and regularly case conferencing on neuropsychiatric symptoms in nursing homes: a cluster randomized trial
title_full_unstemmed The short-term effect of a modified comprehensive geriatric assessment and regularly case conferencing on neuropsychiatric symptoms in nursing homes: a cluster randomized trial
title_short The short-term effect of a modified comprehensive geriatric assessment and regularly case conferencing on neuropsychiatric symptoms in nursing homes: a cluster randomized trial
title_sort short term effect of a modified comprehensive geriatric assessment and regularly case conferencing on neuropsychiatric symptoms in nursing homes a cluster randomized trial
topic Behavioural symptoms
Case conferencing
Cluster RCT
Cognitive impairment
Comprehensive geriatric assessment
Dementia; Long term facilities
url https://doi.org/10.1186/s12877-022-02976-x
work_keys_str_mv AT geirtorestensvik theshorttermeffectofamodifiedcomprehensivegeriatricassessmentandregularlycaseconferencingonneuropsychiatricsymptomsinnursinghomesaclusterrandomizedtrial
AT annesofiehelvik theshorttermeffectofamodifiedcomprehensivegeriatricassessmentandregularlycaseconferencingonneuropsychiatricsymptomsinnursinghomesaclusterrandomizedtrial
AT gørillhaugan theshorttermeffectofamodifiedcomprehensivegeriatricassessmentandregularlycaseconferencingonneuropsychiatricsymptomsinnursinghomesaclusterrandomizedtrial
AT aslaksteinsbekk theshorttermeffectofamodifiedcomprehensivegeriatricassessmentandregularlycaseconferencingonneuropsychiatricsymptomsinnursinghomesaclusterrandomizedtrial
AT øyvindsalvesen theshorttermeffectofamodifiedcomprehensivegeriatricassessmentandregularlycaseconferencingonneuropsychiatricsymptomsinnursinghomesaclusterrandomizedtrial
AT sigridnakrem theshorttermeffectofamodifiedcomprehensivegeriatricassessmentandregularlycaseconferencingonneuropsychiatricsymptomsinnursinghomesaclusterrandomizedtrial
AT geirtorestensvik shorttermeffectofamodifiedcomprehensivegeriatricassessmentandregularlycaseconferencingonneuropsychiatricsymptomsinnursinghomesaclusterrandomizedtrial
AT annesofiehelvik shorttermeffectofamodifiedcomprehensivegeriatricassessmentandregularlycaseconferencingonneuropsychiatricsymptomsinnursinghomesaclusterrandomizedtrial
AT gørillhaugan shorttermeffectofamodifiedcomprehensivegeriatricassessmentandregularlycaseconferencingonneuropsychiatricsymptomsinnursinghomesaclusterrandomizedtrial
AT aslaksteinsbekk shorttermeffectofamodifiedcomprehensivegeriatricassessmentandregularlycaseconferencingonneuropsychiatricsymptomsinnursinghomesaclusterrandomizedtrial
AT øyvindsalvesen shorttermeffectofamodifiedcomprehensivegeriatricassessmentandregularlycaseconferencingonneuropsychiatricsymptomsinnursinghomesaclusterrandomizedtrial
AT sigridnakrem shorttermeffectofamodifiedcomprehensivegeriatricassessmentandregularlycaseconferencingonneuropsychiatricsymptomsinnursinghomesaclusterrandomizedtrial