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Objective: To evaluate the effectiveness of a training and support intervention for nursing home staff in reducing the proportion of residents with dementia who are prescribed neuroleptics. Design: Cluster randomised controlled trial with blinded assessment of outcome. Setting: 12 specialist nursing homes for people with dementia in London, Newcastle, and Oxford. Participants: Residents of the 12 nursing homes; numbers varied during the study period. Intervention: Training and support intervention delivered to nursing home staff over 10 months, focusing on alternatives to drugs for the management of agitated behaviour in dementia. Main outcome measures: Proportion of residents in each home who were prescribed neuroleptics and mean levels of agitated and disruptive behaviour (Cohen-Mansfield agitation inventory) in each home at 12 months. Results: At 12 months the proportion of residents taking neuroleptics in the intervention homes (23.0%) was significantly lower than that in the control homes (42.1%): average reduction in neuroleptic use 19.1% (95% confidence interval 0.5% to 37.7%). No significant differences were found in the levels of agitated or disruptive behaviour between intervention and control homes. Conclusions: Promotion of person centred care and good practice in the management of patients with dementia with behavioural symptoms provides an effective alternative to neuroleptics.

Original publication

DOI

10.1136/bmj.38782.575868.7C

Type

Journal article

Journal

British Medical Journal

Publication Date

01/04/2006

Volume

332

Pages

756 - 758