Dementia Mental and Behavioural Disorders Dementia
Conditions
Interventions
The study involves:
For people with dementia - a medication review to support appropriate prescribing by an experienced specialist pharmacist. Follow-up to assess the impact of the med
Sponsors
Aston University
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Receiving medication (including but not limited to medicines in British National Formulary [BNF] sections 4.1/4.2/4.3/4.11) to treat behaviour that challenges 2. Resident within a long-term care facility 3. Registered with a West Midlands GP (who has also agreed to participate) 4. Dementia confirmed (dementia register, documentation of relevant read codes, confirmation of diagnosis via communication from old age psychiatry, memory clinic or clinical psychologist) 5. Patient or personal consultee willing to provide consent/assent 6. A proxy informant (key worker or staff member with close working relationship) who can clearly communicate in English available
Exclusion criteria
Exclusion criteria: 1. Patient or personal consultee unable or unwilling to provide consent or lacks necessary English-language skills 2. On palliative care register, or has pathology requiring complex specialist medication 3. Risk of harm in line with Alzheimer Society guidance (guidelines published in 2011, currently being updated and therefore not available) 4. Severe mental illness (e.g. schizophrenia) where psychotropic treatment should be continued
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Neuropsychiatric symptoms, assessed using the Neuropsychiatric Inventory (NPI). A specific nursing home version (NPI-MH) designed for interviewing professional care staff will be used. The decrease in the NPI-MH change score between baseline and 3 months will be the primary measure; it will also be collected at 6 weeks and 6 months. A decrease in 4 points, or more will be considered a clinically meaningful change in the NPI-NH. | — |
Secondary
| Measure | Time frame |
|---|---|
| Collected at baseline (before the medication review), 6 weeks and 3 and 6 months (unless stated): 1. Quality of life (QoL), measured using DEMQoL and EuroQoL EQ-5D (proxy versions). Participants may not be able to respond and to reduce any “proxy effect” caregivers will be requested to respond “as if” they were the person with dementia (EQ-5D only collected at baseline, 3 and 6 months; DEMQoL collected at all time points) 2. Cognitive test: standardised Mini-Mental State Examination (sMMSE) collected at baseline, 6 weeks and 3 months) 3. All prescribed medication 4. Costs: a modified version of the Client Services Receipt Inventory (CSRI) will be used to monitor levels of resource use associated with the medication review (including preparation and recommendations) and the use of other NHS and PSS (Personal Social Services) resource items e.g. medication utilisation, GP services and hospital visits/admissions. This will be completed by proxy. Only collected at baseline, 3 and 6 months | — |
Countries
England, United Kingdom
Outcome results
None listed