Improving the management of behaviour that challenges associated with dementia in care homes:protocol for pharmacy-health psychology intervention feasibility study

Maidment, Ian D., Shaw, Rachel L., Killick, Kirsty, Damery, Sarah, Hilton, Andrea, Wilcock, Jane, Barnes, Nigel, Brown, Graeme, Gillespie, Sarah, Fox, Chris, Barton, Garry, Iliffe, Steve and Seare, Nichola (2016). Improving the management of behaviour that challenges associated with dementia in care homes:protocol for pharmacy-health psychology intervention feasibility study. BMJ Open, 6 (3),

Abstract

INTRODUCTION: The inappropriate use of antipsychotics in people with dementia for behaviour that challenges is associated with an estimated 1800 deaths annually. However, solely focusing on antipsychotics may transfer prescribing to other equally dangerous psychotropics. Little is known about the role of pharmacists in the management of psychotropics used to treat behaviours that challenge. This research aims to determine whether it is feasible to implement and measure the effectiveness of a combined pharmacy-health psychology intervention incorporating a medication review and staff training package to limit the prescription of psychotropics to manage behaviour that challenges in care home residents with dementia. METHODS/ANALYSIS: 6 care homes within the West Midlands will be recruited. People with dementia receiving medication for behaviour that challenges, or their personal consultee, will be approached regarding participation. Medication used to treat behaviour that challenges will be reviewed by the pharmacist, in collaboration with the general practitioner (GP), person with dementia and carer. The behavioural intervention consists of a training package for care home staff and GPs promoting person-centred care and treating behaviours that challenge as an expression of unmet need. The primary outcome measure is the Neuropsychiatric Inventory-Nursing Home version (NPI-NH). Other outcomes include quality of life (EQ-5D and DEMQoL), cognition (sMMSE), health economic (CSRI) and prescribed medication including whether recommendations were implemented. Outcome data will be collected at 6 weeks, and 3 and 6 months. Pretraining and post-training interviews will explore stakeholders' expectations and experiences of the intervention. Data will be used to estimate the sample size for a definitive study. ETHICS/DISSEMINATION: The project has received a favourable opinion from the East Midlands REC (15/EM/3014). If potential participants lack capacity, a personal consultee will be consulted regarding participation in line with the Mental Capacity Act. Results will be published in peer-reviewed journals and presented at conferences.

Publication DOI: https://doi.org/10.1136/bmjopen-2015-010279
Divisions: Life & Health Sciences
Life & Health Sciences > Pharmacy
Life & Health Sciences > Chronic and Communicable Conditions
Life & Health Sciences > Applied Health Research Group
Life & Health Sciences > Psychology
Additional Information: This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Uncontrolled Keywords: Medicine(all)
Full Text Link: http://bmjopen. ... ent/6/3/e010279
Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
Published Date: 2016-03-23
Authors: Maidment, Ian D. ( 0000-0003-4152-9704)
Shaw, Rachel L. ( 0000-0002-0438-7666)
Killick, Kirsty
Damery, Sarah
Hilton, Andrea
Wilcock, Jane
Barnes, Nigel
Brown, Graeme
Gillespie, Sarah
Fox, Chris
Barton, Garry
Iliffe, Steve
Seare, Nichola

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License: Creative Commons Attribution


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