Sammendrag
Objectives: This study aimed to examine if Dementia Care Mapping (DCM) or the VIPS practice model (VPM) were more
effective than educating staff about dementia (control) in reducing agitation and other neuropsychiatric symptoms and to enhance
quality of life in nursing-home (NH) patients.
Methods: A ten-month three-armed cluster-randomized controlled trial compared DCM and VPM with control. Of 624 NH patients
with dementia from 14 NH, 446 completed follow-up. Primary outcome was change in score on the Brief Agitation Rating Scale
(BARS). Secondary outcomes were change in score on the Neuropsychiatric Inventory Questionnaire (NPI-Q), the Cornell Scale for
Depression in Dementia (CSDD), and the Quality of Life in late-stage Dementia scale (QUALID).
Results: Change in BARS score did not differ significantly between DCM and control or between VPM and control after 10
months. DCM vs. control, -2.0 95% confidence interval (-5.1; 1.1); VIPS vs. control: -1.1 (-3.8; 1.6). Significant reduction in
symptoms were found for secondary outcomes, NPI-Q-10 sum-score: DCM vs. control, - 2.7 (-4.6; -0.7); VIPS vs. control, -2.4 (-4.1;
-0.6); NPI-Q agitation: DCM vs. control, -0.9 (-1.7; -0.04); VIPS vs. control, -0.9 (-1.6; -0.1); NPI-Q psychosis: DCM vs. control, -
0.9 (-1.4; -0.3) ; VIPS vs. control, -0.6 (-1.1; -0.04);. QUALID score: DCM vs. control, -3.0 (-5.5; -0.6); and CSDD score: VIPS vs.
control, -2.6 (-4.8; -0.4).
Conclusion: Even though the study failed to find a significant effect on the primary outcome, it adds to the growing but not
conclusive evidence that PCC may reduce and prevent agitation and other NPS in nursing-home patients with dementia. The positive
findings of the effect on the patient’s QoL and depressive symptoms have not been shown in previous studies and need to be further
investigated.
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