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首页> 外文期刊>BMC Psychiatry >Medication review plus person-centred care: a feasibility study of a pharmacy-health psychology dual intervention to improve care for people living with dementia
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Medication review plus person-centred care: a feasibility study of a pharmacy-health psychology dual intervention to improve care for people living with dementia

机译：药物审查加以人为本的护理：药物-健康心理学双重干预以改善对痴呆症患者的护理的可行性研究

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“Behaviour that Challenges” is common in people living with dementia, resident in care homes and historically has been treated with anti-psychotics. However, such usage is associated with 1800 potentially avoidable deaths annually in the UK. This study investigated the feasibility of a full clinical trial of a specialist dementia care pharmacist medication review combined with a health psychology intervention for care staff to limit the use of psychotropics. This paper focuses on feasibility; including recruitment and retention, implementation of medication change recommendations and the experiences and expectations of care staff. West Midlands care homes and individuals meeting the inclusion criteria (dementia diagnosis; medication for behaviour that challenges), or their personal consultee, were approached for consent. A specialist pharmacist reviewed medication. Care home staff received an educational behaviour change intervention in a three-hour session promoting person-centred care. Primary healthcare staff received a modified version of the training. The primary outcome measure was the Neuropsychiatric Inventory-Nursing Home version at 3?months. Other outcomes included quality of life, cognition, health economics and prescribed medication. A qualitative evaluation explored expectations and experiences of care staff. Five care homes and 34 of 108 eligible residents (31.5%) were recruited, against an original target of 45 residents across 6 care homes. Medication reviews were conducted for 29 study participants (85.3%) and the pharmacist recommended stopping or reviewing medication in 21 cases (72.4%). Of the recommendations made, 57.1% (12 of 21) were implemented, and implementation (discontinuation) took a mean of 98.4?days. In total, 164 care staff received training and 21 were interviewed. Care staff reported a positive experience of the intervention and post intervention adopting a more holistic patient-centred approach. The intervention contained two elements; staff training and medication review. It was feasible to implement the staff training, and the training appeared to increase the ability and confidence of care staff to manage behaviour that challenges without the need for medication. The medication review would require significant modification for full trial partly related to the relatively limited uptake of the recommendations made, and delay in implementation. ISRCTN58330068 . Registered 15 October 2017. Retrospectively registered.
机译：“挑战行为”在痴呆症患者，护理院居民中很常见，并且历来都接受过抗精神病药治疗。然而，在英国，这种用法每年导致1800例可避免的死亡。这项研究调查了一项针对痴呆症护理药剂师的专业药物审查的全面临床试验以及针对护理人员以限制使用精神药物的健康心理干预措施的可行性的研究。本文关注可行性。包括招聘和保留，实施药物变更建议以及护理人员的经验和期望。向西米德兰兹郡的敬老院和符合纳入标准（痴呆症诊断;针对行为挑战的药物）的个人或他们的私人顾问征得他们的同意。一位专业药剂师对药物进行了审查。护理院工作人员在三个小时的会议中接受了教育行为改变干预，以个人为本。初级保健人员接受了培训的修订版。主要结局指标是3个月时的神经精神病学目录-疗养院版本。其他结果包括生活质量，认知，健康经济学和处方药。定性评估探索了护理人员的期望和经验。招募了5家养老院和108名合格居民中的34名（31.5％），而最初目标是在6家养老院中分配45名居民。对29名研究参与者（85.3％）进行了药物审查，药剂师建议21例（72.4％）停止或审查药物。在提出的建议中，实施了57.1％（21个中的12个），实施（中止）平均花费98.4天。共有164名护理人员接受了培训，并接受了21次面试。护理人员报告了干预方面的积极经验，并且在干预后采用了更全面的以患者为中心的方法。干预包含两个要素;人员培训和药物审查。实施员工培训是可行的，并且该培训似乎增强了护理人员处理挑战行为而无需药物治疗的能力和信心。药物审查将需要对整个试验进行重大修改，部分原因与对建议的接受程度相对有限以及实施延迟有关。 ISRCTN58330068。 2017年10月15日注册。追溯注册。

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