Effect of person-centred care on antipsychotic drug use in nursing homes (EPCentCare): study protocol for a cluster-randomised controlled trial

Richter, Christin; Berg, Almuth; Fleischer, Steffen; Köpke, Sascha; Balzer, Katrin; Fick, Eva-Maria; Sönnichsen, Andreas; Löscher, Susanne; Vollmar, Horst Christian; Haastert, Burkhard; Icks, Andrea; Dintsios, Charalabos-Markos; Mann, Eva; Wolf, Ursula; Meyer, Gabriele

doi:10.1186/s13012-015-0268-3

Cited by 26 publications

(24 citation statements)

References 51 publications

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“…Nesta faixa etária, as doenças neurodegenerativas como, por exemplo, a doença de Parkinson ou a doença de Alzheimer causam uma elevada prevalência de problemas de saúde mental, como transtornos de ansiedade e depressão, o que leva ao aumento do consumo de drogas psicoativas. (13) .…”

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“…Em relação ao uso de medicações como fator de risco para quedas, identifica-se que o uso de antidepressivos (em especial antidepressivos tricíclicos) e outras drogas psicoativas são capazes de influenciar o equilíbrio e o controle postural e; a perda de concentração, com baixa atenção aos obstáculos. O ambiente é um facilitador para diminuir a ocorrência de quedas ou aumentá-las (14) .…”

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“…Os medicamentos psicotrópicos são comumente prescritos (13) . Destacam-se, entre eles, os benzodiazepínicos como, os agentes de ação prolongada, antidepressivos e antipsicóticos.…”

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<b> Quedas em pacientes psiquiátricos: uma revisão integrativa/ Psychiatric patients’ falls: an integrative review

et al. 2019

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Objetivo: caracterizar a produção sobre o evento quedas em pacientes psiquiátricos adultos. Método:Trata-se de uma revisão integrativa baseada nos pressupostos teórico-metodológicos de Whittemore. Para coleta de dados utilizou-se os descritores: acidentes por quedas, saúde mental, psiquiatria, enfermagem psiquiátrica e enfermagem nas bases de dados Lilacs, MedLine, PubMed, Cinahl e Embase. Por meio dos critérios de inclusão e instrumentos de controle de qualidade e níveis de evidências, totalizou-se uma amostra de 57 artigos. Resultados: Emergiu da revisão integrativa aspectos referentes aos fatores de risco de pacientes psiquiátricos, mecanismos e instrumentos para avaliar as quedas em pacientes psiquiátricos e intervenções relacionadas à prevenção de quedas. Conclusão: Portanto a produção científica apresenta elementos fundamentais sobre o evento quedas em paciente psiquiátrico, contribuindo para a segurança desses pacientes nas unidades de internações psiquiátricas.

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<b> Quedas em pacientes psiquiátricos: uma revisão integrativa/ Psychiatric patients’ falls: an integrative review

et al. 2019

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“…Both authors of the original QoL-AD and the QoL-AD NH were informed about all steps of the crosscultural adaptation process and approved the backtranslation of the final German QoL-AD NH (self and proxy). The next stage of the cross-cultural adaptation will be an evaluation of the reliability and validity in a large German sample of people with dementia (Richter et al, 2015). Possible differences in reliability and validity of the QoL-AD NH proxy (patient-proxy or proxy-proxy) will be investigated, aiming for a better understanding of the best proxyperspective regarding the Qol-AD NH.…”

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“…The convenience sample consisted of 29 professional caregivers from four NHs who were interviewed individually (n = 14) or in three focus groups (n = 15). NHs collaborating in previous and recent studies were asked for participation (Köpke et al, 2012;Richter et al, 2015). In all NHs both a focus group interview and individual interviews were conducted.…”

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Cross-cultural adaptation of the German version of the Quality of Life in Alzheimer's Disease scale - Nursing Home version (QoL-AD NH)

Dichter

Wolschon

Meyer

et al. 2016

Int. Psychogeriatr.

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Dementia is a chronic and currently incurable syndrome. Therefore, quality of life (QoL) is a major goal when caring for people with dementia (Gibson et al., 2010) and a major outcome in dementia research (Moniz-Cook et al., 2008). The measurement of QoL, especially proxy-rating, is challenging because of the proxy-perspective (Pickard and Knight, 2005), reliability (Dichter et al., 2016), validity (O'Rourke et al., 2015), and responsiveness (Perales et al., 2013). Probably due to these challenges, it has not been possible to show positive effects for QoL in almost all non-pharmacological interventions for people with dementia (Cooper et al., 2012). One recommended (Moniz-Cook et al., 2008) and frequently used instrument is the Quality of Life in Alzheimer's Disease scale (QoL-AD), which was originally developed in the US for community-dwelling people with dementia. The QoL-AD consists of 13 items based on a 4-point Likert scale ranging from “1”=poor to “4”=excellent (Logsdon et al., 1999). The original instrument has been adapted for people living in nursing homes (NH) by Edelmann et al. (2005).

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Interventions for preventing falls in older people in care facilities and hospitals

Cameron

Dyer²,

Panagoda

et al. 2018

Cochrane Database of Systematic Reviews

355

370

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Background Falls in care facilities and hospitals are common events that cause considerable morbidity and mortality for older people. This is an update of a review first published in 2010 and updated in 2012. Objectives To assess the effects of interventions designed to reduce the incidence of falls in older people in care facilities and hospitals. Search methods We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (August 2017); Cochrane Central Register of Controlled Trials (2017, Issue 8); and MEDLINE, Embase, CINAHL and trial registers to August 2017. Selection criteria Randomised controlled trials of interventions for preventing falls in older people in residential or nursing care facilities, or hospitals. Data collection and analysis One review author screened abstracts; two review authors screened full‐text articles for inclusion. Two review authors independently performed study selection, 'Risk of bias' assessment and data extraction. We calculated rate ratios (RaR) with 95% confidence intervals (CIs) for rate of falls and risk ratios (RRs) and 95% CIs for outcomes such as risk of falling (number of people falling). We pooled results where appropriate. We used GRADE to assess the quality of evidence. Main results Thirty‐five new trials (77,869 participants) were included in this update. Overall, we included 95 trials (138,164 participants), 71 (40,374 participants; mean age 84 years; 75% women) in care facilities and 24 (97,790 participants; mean age 78 years; 52% women) in hospitals. The majority of trials were at high risk of bias in one or more domains, mostly relating to lack of blinding. With few exceptions, the quality of evidence for individual interventions in either setting was generally rated as low or very low. Risk of fracture and adverse events were generally poorly reported and, where reported, the evidence was very low‐quality, which means that we are uncertain of the estimates. Only the falls outcomes for the main comparisons are reported here. Care facilities Seventeen trials compared exercise with control (typically usual care alone). We are uncertain of the effect of exercise on rate of falls (RaR 0.93, 95% CI 0.72 to 1.20; 2002 participants, 10 studies; I² = 76%; very low‐quality evidence). Exercise may make little or no difference to the risk of falling (RR 1.02, 95% CI 0.88 to 1.18; 2090 participants, 10 studies; I² = 23%; low‐quality evidence). There is low‐quality evidence that general medication review (tested in 12 trials) may make little or no difference to the rate of falls (RaR 0.93, 95% CI 0.64 to 1.35; 2409 participants, 6 studies; I² = 93%) or the risk of falling (RR 0.93, 95% CI 0.80 to 1.09; 5139 participants, 6 studies; I² = 48%). There is moderate‐quality evidence that vitamin D supplementation (4512 particip...

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Effect of person-centred care on antipsychotic drug use in nursing homes (EPCentCare): study protocol for a cluster-randomised controlled trial

Cited by 26 publications

References 51 publications

<b> Quedas em pacientes psiquiátricos: uma revisão integrativa/ Psychiatric patients’ falls: an integrative review

<b> Quedas em pacientes psiquiátricos: uma revisão integrativa/ Psychiatric patients’ falls: an integrative review

Cross-cultural adaptation of the German version of the Quality of Life in Alzheimer's Disease scale - Nursing Home version (QoL-AD NH)

Interventions for preventing falls in older people in care facilities and hospitals

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