Brief psychosocial therapy for the treatment of agitation in Alzheimer disease (the CALM-AD trial).
BACKGROUND: Good practice guidelines state that a psychological intervention should usually precede pharmacotherapy, but there are no data evaluating the feasibility of psychological interventions used in this way. METHODS: At the first stage of a randomized blinded placebo-controlled trial, 318 pat...
| Hlavní autoři: | , , , , , , , , , , , , , , , , |
|---|---|
| Médium: | Journal article |
| Jazyk: | English |
| Vydáno: |
2009
|
| _version_ | 1826294048800899072 |
|---|---|
| author | Ballard, C Brown, R Fossey, J Douglas, S Bradley, P Hancock, J James, I Juszczak, E Bentham, P Burns, A Lindesay, J Jacoby, R O'Brien, J Bullock, R Johnson, T Holmes, C Howard, R |
| author_facet | Ballard, C Brown, R Fossey, J Douglas, S Bradley, P Hancock, J James, I Juszczak, E Bentham, P Burns, A Lindesay, J Jacoby, R O'Brien, J Bullock, R Johnson, T Holmes, C Howard, R |
| author_sort | Ballard, C |
| collection | OXFORD |
| description | BACKGROUND: Good practice guidelines state that a psychological intervention should usually precede pharmacotherapy, but there are no data evaluating the feasibility of psychological interventions used in this way. METHODS: At the first stage of a randomized blinded placebo-controlled trial, 318 patients with Alzheimer disease (AD) with clinically significant agitated behavior were treated in an open design with a psychological intervention (brief psychosocial therapy [BPST]) for 4 weeks, preceding randomization to pharmacotherapy. The therapy involved social interaction, personalized music, or removal of environmental triggers. RESULTS: Overall, 318 patients with AD completed BPST with an improvement of 5.6 points on the total Cohen-Mansfield Agitation Inventory (CMAI; mean [SD], 63.3 [16.0] to 57.7 [18.4], t = 4.8, df = 317, p < 0.0001). Therapy worksheets were completed in six of the eight centers, with the key elements of the intervention delivered according to the manual for >95% of patients. More detailed evaluation of outcome was completed for the 198 patients with AD from these centers, who experienced a mean improvement of 6.6 points on the total CMAI (mean [SD], 62.2 [14.3] to 55.6 [15.8], t = 6.5, df = 197, p < 0.0001). Overall, 43% of participants achieved a 30% improvement in their level of agitation. CONCLUSION: The specific attributable benefits of BPST cannot be determined from an open trial. However, the BPST therapy was feasible and was successfully delivered according to an operationalized manual. The encouraging outcome indicates the need for a randomized controlled trial of BPST. |
| first_indexed | 2024-03-07T03:39:37Z |
| format | Journal article |
| id | oxford-uuid:bd708602-fdf6-4dd1-bb85-549a42ef6061 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T03:39:37Z |
| publishDate | 2009 |
| record_format | dspace |
| spelling | oxford-uuid:bd708602-fdf6-4dd1-bb85-549a42ef60612022-03-27T05:31:54ZBrief psychosocial therapy for the treatment of agitation in Alzheimer disease (the CALM-AD trial).Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:bd708602-fdf6-4dd1-bb85-549a42ef6061EnglishSymplectic Elements at Oxford2009Ballard, CBrown, RFossey, JDouglas, SBradley, PHancock, JJames, IJuszczak, EBentham, PBurns, ALindesay, JJacoby, RO'Brien, JBullock, RJohnson, THolmes, CHoward, RBACKGROUND: Good practice guidelines state that a psychological intervention should usually precede pharmacotherapy, but there are no data evaluating the feasibility of psychological interventions used in this way. METHODS: At the first stage of a randomized blinded placebo-controlled trial, 318 patients with Alzheimer disease (AD) with clinically significant agitated behavior were treated in an open design with a psychological intervention (brief psychosocial therapy [BPST]) for 4 weeks, preceding randomization to pharmacotherapy. The therapy involved social interaction, personalized music, or removal of environmental triggers. RESULTS: Overall, 318 patients with AD completed BPST with an improvement of 5.6 points on the total Cohen-Mansfield Agitation Inventory (CMAI; mean [SD], 63.3 [16.0] to 57.7 [18.4], t = 4.8, df = 317, p < 0.0001). Therapy worksheets were completed in six of the eight centers, with the key elements of the intervention delivered according to the manual for >95% of patients. More detailed evaluation of outcome was completed for the 198 patients with AD from these centers, who experienced a mean improvement of 6.6 points on the total CMAI (mean [SD], 62.2 [14.3] to 55.6 [15.8], t = 6.5, df = 197, p < 0.0001). Overall, 43% of participants achieved a 30% improvement in their level of agitation. CONCLUSION: The specific attributable benefits of BPST cannot be determined from an open trial. However, the BPST therapy was feasible and was successfully delivered according to an operationalized manual. The encouraging outcome indicates the need for a randomized controlled trial of BPST. |
| spellingShingle | Ballard, C Brown, R Fossey, J Douglas, S Bradley, P Hancock, J James, I Juszczak, E Bentham, P Burns, A Lindesay, J Jacoby, R O'Brien, J Bullock, R Johnson, T Holmes, C Howard, R Brief psychosocial therapy for the treatment of agitation in Alzheimer disease (the CALM-AD trial). |
| title | Brief psychosocial therapy for the treatment of agitation in Alzheimer disease (the CALM-AD trial). |
| title_full | Brief psychosocial therapy for the treatment of agitation in Alzheimer disease (the CALM-AD trial). |
| title_fullStr | Brief psychosocial therapy for the treatment of agitation in Alzheimer disease (the CALM-AD trial). |
| title_full_unstemmed | Brief psychosocial therapy for the treatment of agitation in Alzheimer disease (the CALM-AD trial). |
| title_short | Brief psychosocial therapy for the treatment of agitation in Alzheimer disease (the CALM-AD trial). |
| title_sort | brief psychosocial therapy for the treatment of agitation in alzheimer disease the calm ad trial |
| work_keys_str_mv | AT ballardc briefpsychosocialtherapyforthetreatmentofagitationinalzheimerdiseasethecalmadtrial AT brownr briefpsychosocialtherapyforthetreatmentofagitationinalzheimerdiseasethecalmadtrial AT fosseyj briefpsychosocialtherapyforthetreatmentofagitationinalzheimerdiseasethecalmadtrial AT douglass briefpsychosocialtherapyforthetreatmentofagitationinalzheimerdiseasethecalmadtrial AT bradleyp briefpsychosocialtherapyforthetreatmentofagitationinalzheimerdiseasethecalmadtrial AT hancockj briefpsychosocialtherapyforthetreatmentofagitationinalzheimerdiseasethecalmadtrial AT jamesi briefpsychosocialtherapyforthetreatmentofagitationinalzheimerdiseasethecalmadtrial AT juszczake briefpsychosocialtherapyforthetreatmentofagitationinalzheimerdiseasethecalmadtrial AT benthamp briefpsychosocialtherapyforthetreatmentofagitationinalzheimerdiseasethecalmadtrial AT burnsa briefpsychosocialtherapyforthetreatmentofagitationinalzheimerdiseasethecalmadtrial AT lindesayj briefpsychosocialtherapyforthetreatmentofagitationinalzheimerdiseasethecalmadtrial AT jacobyr briefpsychosocialtherapyforthetreatmentofagitationinalzheimerdiseasethecalmadtrial AT obrienj briefpsychosocialtherapyforthetreatmentofagitationinalzheimerdiseasethecalmadtrial AT bullockr briefpsychosocialtherapyforthetreatmentofagitationinalzheimerdiseasethecalmadtrial AT johnsont briefpsychosocialtherapyforthetreatmentofagitationinalzheimerdiseasethecalmadtrial AT holmesc briefpsychosocialtherapyforthetreatmentofagitationinalzheimerdiseasethecalmadtrial AT howardr briefpsychosocialtherapyforthetreatmentofagitationinalzheimerdiseasethecalmadtrial |