Impact of person-centred care training and person-centred activities on quality of life, agitation, and antipsychotic use in people with dementia living in nursing homes: A cluster-randomised controlled trial

1. Alzheimer’s Disease International. World Alzheimer report 2009. London: Alzheimer’s Disease International; 2009 [cited 2018 Jan 8]. Available from: http://www.alz.co.uk/research/files/WorldAlzheimerReport.pdf.

2. Alzheimer’s Disease International. World Alzheimer’s report 2013: journey of caring—an analysis of long-term care in dementia. London: Alzheimer’s Disease International; 2013 [cited 2018 Jan 8]. Available from: http://www.alz.co.uk/research/WorldAlzheimerReport2013ExecutiveSummary.pdf.

3. Ballard C, Corbett A, Howard R. Prescription of antipsychotics in people with dementia. Br J Psychiatry. 2014;205(1):4–5. doi: 10.1192/bjp.bp.113.128710 24986385

4. Ballard C, Corbett A. Agitation and aggression in people with Alzheimer’s disease. Curr Opin Psychiatry. 2013;26(3):252–9. doi: 10.1097/YCO.0b013e32835f414b 23528917

5. Testad I, Corbett A, Aarsland D, Lexow KO, Fossey J, Woods B, et al. The value of personalized psychosocial interventions to address behavioral and psychological symptoms in people with dementia living in care home settings: a systematic review. Int Psychogeriatr. 2014;26(7):1083–98. doi: 10.1017/S1041610214000131 24565226

6. Chenoweth L, King MT, Jeon YH, Brodaty H, Stein-Parbury J, Norman R, et al. Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial. Lancet Neurol. 2009;8(4):317–25. doi: 10.1016/S1474-4422(09)70045-6 19282246

7. Fossey J, Ballard C, Juszczak E, James I, Alder N, Jacoby R, et al. Effect of enhanced psychosocial care on antipsychotic use in nursing home residents with severe dementia: cluster randomised trial. BMJ. 2006;332(7544):756–61. doi: 10.1136/bmj.38782.575868.7C 16543297

8. Fossey J, Masson S, Stafford J, Lawrence V, Corbett A, Ballard C. The disconnect between evidence and practice: a systematic review of person-centred interventions and training manuals for care home staff working with people with dementia. Int J Geriatr Psychiatry. 2014;29(8):797–807. doi: 10.1002/gps.4072 24535885

9. Ballard C, Orrell M, YongZhong S, Moniz-Cook E, Stafford J, Whittaker R, et al. Impact of antipsychotic review and nonpharmacological intervention on antipsychotic use, neuropsychiatric symptoms, and mortality in people with dementia living in nursing homes: a factorial cluster-randomized controlled trial by the Well-Being and Health for People With Dementia (WHELD) program. Am J Psychiatry. 2016;173(3):252–62. doi: 10.1176/appi.ajp.2015.15010130 26585409

10. Corbett A, Smith J, Creese B, Ballard C. Treatment of behavioral and psychological symptoms of Alzheimer’s disease. Curr Treat Options Neurol. 2012;14(2):113–25. doi: 10.1007/s11940-012-0166-9 22328204

11. Ballard CG, Margallo-Lana M, Fossey J, Reichelt K, Myint P, Potkins D, et al. A 1-year follow-up study of behavioral and psychological symptoms in dementia among people in care environments. J Clin Psychiatry. 2001;62(8):631–6. 11561936

12. Ballard C, Howard R. Neuroleptic drugs in dementia: benefits and harm. Nat Rev Neurosci. 2006;7(6):492–500. doi: 10.1038/nrn1926 16715057

13. Schneider LS, Tariot PN, Dagerman KS, Davis SM, Hsiao JK, Ismail MS, et al. Effectiveness of atypical antipsychotic drugs in patients with Alzheimer’s disease. N Engl J Med. 2006;355(15):1525–38. doi: 10.1056/NEJMoa061240 17035647

14. Ballard C, Hanney ML, Theodoulou M, Douglas S, McShane R, Kossakowski K, et al. The dementia antipsychotic withdrawal trial (DART-AD): long-term follow-up of a randomised placebo-controlled trial. Lancet Neurol. 2009;8(2):151–7. doi: 10.1016/S1474-4422(08)70295-3 19138567

15. Ballard CG, Gauthier S, Cummings JL, Brodaty H, Grossberg GT, Robert P, et al. Management of agitation and aggression associated with Alzheimer disease. Nat Rev Neurol. 2009;5(5):245–55. doi: 10.1038/nrneurol.2009.39 19488082

16. Ballard C, Creese B, Corbett A, Aarsland D. Atypical antipsychotics for the treatment of behavioral and psychological symptoms in dementia, with a particular focus on longer term outcomes and mortality. Expert Opin Drug Saf. 2011;10(1):35–43. doi: 10.1517/14740338.2010.506711 20684745

17. Schneider LS, Dagerman KS, Insel P. Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials. JAMA. 2005;294(15):1934–43. doi: 10.1001/jama.294.15.1934 16234500

18. Alzheimer’s Society. Optimising treatment and care for behavioural and psychological symptoms of dementia: a best practice guide for health and social care professionals. London: Alzheimer’s Society; 2011.

19. Centers for Medicare and Medicaid Services Center of Clinical Standards and Quality. CMS 2012 nursing home action plan: action plan for further improvement of nursing home quality. Baltimore: Centers for Medicare and Medicaid Services; 2012.

20. Porsteinsson AP, Drye LT, Pollock BG, Devanand DP, Frangakis C, Ismail Z, et al. Effect of citalopram on agitation in Alzheimer disease: the CitAD randomized clinical trial. JAMA. 2014;311(7):682–91. doi: 10.1001/jama.2014.93 24549548

21. Cummings JL, Lyketsos CG, Peskind ER, Porsteinsson AP, Mintzer JE, Scharre DW, et al. Effect of dextromethorphan-quinidine on agitation in patients with Alzheimer disease dementia: a randomized clinical trial. JAMA. 2015;314(12):1242–54. doi: 10.1001/jama.2015.10214 26393847

22. Livingston G, Johnston K, Katona C, Paton J, Lyketsos CG, Old Age Task Force of the World Federation of Biological Psychiatry. Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia. Am J Psychiatry. 2005;162(11):1996–2021. doi: 10.1176/appi.ajp.162.11.1996 16263837

23. Teri L, Logsdon RG, Uomoto J, McCurry SM. Behavioral treatment of depression in dementia patients: a controlled clinical trial. J Gerontol B Psychol Sci Soc Sci. 1997;52(4):P159–66. 9224439

24. Cohen-Mansfield J, Libin A, Marx MS. Nonpharmacological treatment of agitation: a controlled trial of systematic individualized intervention. J Gerontol B Psychol Sci Soc Sci. 2007;62(8):908–16.

25. Whitaker R, Fossey J, Ballard C, Orrell M, Moniz-Cook E, Woods RT, et al. Improving Well-being and Health for People with Dementia (WHELD): study protocol for a randomised controlled trial. Trials. 2014;15:284. doi: 10.1186/1745-6215-15-284 25016303

26. Morris JC. The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology. 1993;43(11):2412–4.

27. Auer S, Reisberg B. The GDS/FAST staging system. Int Psychogeriatr. 1997;9(Suppl 1):167–71.

28. Mulhern B, Rowen D, Brazier J, Smith S, Romeo R, Tait R, et al. Development of DEMQOL-U and DEMQOL-PROXY-U: generation of preference-based indices from DEMQOL and DEMQOL-PROXY for use in economic evaluation. Health Technol Assess. 2013;17(5):v–xv,1–140. doi: 10.3310/hta17050 23402232

29. Cohen-Mansfield J, Marx MS, Rosenthal AS. A description of agitation in a nursing home. J Gerontol. 1989;44(3):M77–84. 2715584

30. Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994;44(12):2308–14. 7991117

31. Wood S, Cummings JL, Hsu MA, Barclay T, Wheatley MV, Yarema KT, et al. The use of the neuropsychiatric inventory in nursing home residents. Characterization and measurement. Am J Geriatr Psychiatry. 2000;8(1):75–83. 10648298

32. Alexopoulos GS, Abrams RC, Young RC, Shamoian CA. Cornell Scale for Depression in Dementia. Biol Psychiatry. 1988;23(3):271–84. 3337862

33. Reynolds T, Thornicroft G, Abas M, Woods B, Hoe J, Leese M, et al. Camberwell Assessment of Need for the Elderly (CANE). Development, validity and reliability. Br J Psychiatry. 2000;176:444–52. 10912220

34. Dean R, Proudfoot R, Lindesay J. The quality of interactions schedule (QUIS): development, reliability and use in the evaluation of two domus units. Int J Geriatr Psychiatry. 1993;8(10):819–26.

35. Abbey J, Piller N, De Bellis A, Esterman A, Parker D, Giles L, et al. The Abbey pain scale: a 1-minute numerical indicator for people with end-stage dementia. Int J Palliat Nurs. 2004;10(1):6–13. doi: 10.12968/ijpn.2004.10.1.12013 14966439

36. Romeo R, Knapp M, Hellier J, Dewey M, Ballard C, Baldwin R, et al. Cost-effectiveness analyses for mirtazapine and sertraline in dementia: randomised controlled trial. Br J Psychiatry. 2013;202:121–8. doi: 10.1192/bjp.bp.112.115212 23258767

37. Knapp M, Iemmi V, Romeo R. Dementia care costs and outcomes: a systematic review. Int J Geriatr Psychiatry. 2013;28(6):551–61. doi: 10.1002/gps.3864 22887331

38. Russell D, Hoare ZS, Whitaker R, Whitaker CJ, Russell IT. Generalized method for adaptive randomization in clinical trials. Stat Med. 2011;30(9):922–34. doi: 10.1002/sim.4175 21284014

39. Data from: Impact of person-centred care training and person-centred activities on quality of life, agitation, and antipsychotic use in people with dementia living in nursing homes: a cluster-randomised controlled trial. Durham (North Carolina): Dryad Digital Depository; 2018. doi: 10.5061/dryad.75373

40. Wetzels RB, Zuidema SU, de Jonghe JF, Verhey FR, Koopmans RT. Determinants of quality of life in nursing home residents with dementia. Dement Geriatr Cogn Disord. 2010;29(3):189–97. doi: 10.1159/000280437 20215750

41. Ballard C, Lana MM, Theodoulou M, Douglas S, McShane R, Jacoby R, et al. A randomised, blinded, placebo-controlled trial in dementia patients continuing or stopping neuroleptics (the DART-AD trial). PLoS Med. 2008;5(4):e76. doi: 10.1371/journal.pmed.0050076 18384230

42. Schneider LS, Pollock VE, Lyness SA. A metaanalysis of controlled trials of neuroleptic treatment in dementia. J Am Geriatr Soc. 1990;38(5):553–63. 1970586