REducing AntiPsychotic use in residential care: Huntington Disease. A pilot Randomised Controlled Trial

A randomised controlled trial comparing a multi-faceted intervention based on a behavioural management clinical pathway for health professionals (MFI), against standard staff outreach education (SSE), in reducing anti-psychotic dosages for people with Huntington Disease (HD) in residential care facilities (RCF)

Status

Completed

Phases

Unknown

Study type

Interventional

Source

ANZCTR

Registry ID

ACTRN12614000083695

Acronym

REAP-HD

Enrollment

Registered

2014-01-22

Start date

2014-02-25

Completion date

2014-09-10

Last updated

2020-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

The rationale for using antipsychotics for behavioural management in Huntington Disease is weak, and antipsychotics are potentially harmful. REAP-HD intends to change clinical practice in residential care facilities (RCFs) so that antipsychotics are used as second line, time-limited therapy subject to regular review. REAP-HD will implement two different strategies, and compare their efficacy in helping health care professionals reduce antipsychotic use.

Interventions

The multi-faceted intervention (MFI) is based on a clinical pathway for management of behavioural symptoms. It comprises a once-off 45 minute presentation and a followup phone call at 1 month.

Study design

Allocation

Randomised controlled trial

Intervention model

Parallel

Primary purpose

Educational / counselling / training

Masking

Blinded (masking used) (Investigator, Outcomes Assessor)

Eligibility

Sex/Gender

All

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

1.Male or Female 18 years or older 2.Clinical HD, and a confirmatory family history OR >= 36 CAG repeats upon genetic testing 3.Living in RCF in NSW- including group homes with 24-hour supervision, hostels and nursing homes 4.Currently receiving a stable dose of regular antipsychotic medications for management of behavioural symptoms, for at least 4 months prior to enrolment (see exclusion criteria). 5.Able to provide informed consent, or have a suitable senior person responsible who is able to provide informed consent.

Exclusion criteria

1.Change of antipsychotic dose within 4 months prior to enrolment 2.Psychotic symptoms (new hallucinations or delusions) within 1 year of enrolment 3.People taking anti-psychotic medications solely for control of chorea 4.Other unstable medical or psychiatric illness, making it unsafe to reduce anti-psychotic dose

Outcome results