| Autor: |
Zarei, Shadi, Colman, Sarah, Rostas, Aviva, Burhan, Amer M., Chu, Li, Davies, Simon JC, Derkach, Peter, Elmi, Sarah, Hussain, Maria, Gerretsen, Philip, Graff-Guerrero, Ariel, Ismail, Zahinoor, Kim, Donna, Krisman, Linda, Moghabghab, Rola, Mulsant, Benoit H., Nair, Vasavan, Pollock, Bruce G., Rej, Soham, Simmons, Jyll |
| Zdroj: |
Journal of Alzheimer's Disease; 2022, Vol. 86 Issue 2, p827-840, 14p |
| Abstrakt: |
Background: Agitation and aggression are common in patients with Alzheimer's disease and related dementias and pose a significant burden on patients, caregivers, and the healthcare systems. Guidelines recommend personalized behavioral interventions as the first-line treatment; however, these interventions are often underutilized. The Standardizing Care for Neuropsychiatric Symptoms and Quality of Life in Dementia (StaN) study (ClinicalTrials.gov Identifier # NCT0367220) is a multisite randomized controlled trial comparing an Integrated Care Pathway, that includes a sequential pharmacological algorithm and structured behavioral interventions, with treatment-as-usual to treat agitation in dementia in long-term care and inpatient settings.Objective: To describe the rationale and design of structured behavioral interventions in the StaN study.Methods: Structured behavioral interventions are designed and implemented based on the following considerations: 1) personalization, 2) evidence base, 3) dose and duration, 4) measurement-based care, and 5) environmental factors and feasibility.Results: The process to design behavioral interventions for each individual starts with a comprehensive assessment, followed by personalized, evidence-based interventions delivered in a standardized manner with ongoing monitoring of global clinical status. Measurement-based care is used to tailor the interventions and integrate them with pharmacotherapy.Conclusion: Individualized behavioral interventions in patients with dementia may be challenging to design and implement. Here we describe a process to design and implement individualized and structured behavioral interventions in the context of a multisite trial in long-term care and inpatient settings. This process can inform the design of behavioral interventions in future trials and in clinical settings for the treatment of agitation in dementia. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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