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The short-term effect of a modified comprehensive geriatric assessment and regularly case conferencing on
Geir-Tore Stensvik1, Anne-Sofie Helvik2,3, Gørill Haugan2,4
1Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. geir.t.stensvik@ntnu.no.
Aims:
To investigate the short-term effect of implementing a modified comprehensive geriatric assessment and regularly case conferencing in nursing homes on neuropsychiatric symptoms.
Background:
Neuropsychiatric symptoms are common and may persist over time in nursing home residents. Evidence of effective interventions is scarce.
Design:
A parallel cluster-randomised controlled trial.
Methods:
The intervention was monthly standardised case conferencing in combination with a modified comprehensive geriatric assessment. The control group received care as usual.
Main Outcome Measure:
The total score on the short version of the Neuropsychiatric Inventory (NPI-Q, 12-items).
Results:
A total of 309 residents at 34 long-term care wards in 17 nursing homes (unit of randomisation) were included. The intervention care units conducted on average two case conference-meetings (range 1-3), discussing a mean of 4.8 (range 1-8) residents. After 3 months, there were no difference of NPI-Q total score between the intervention (-0.4) and the control group (0.5) (estimated mean difference = -1.0, 95% CI -2.4 to 0.5, p = 0.19). There was a difference in favour of the intervention group on one of the secondary outcome measures, the apathy symptoms (-0.5 95% CI: -0.9 to -0.1, p = 0.03).
Conclusion:
In this study there were no short-term effect of case conferencing and modified comprehensive geriatric assessments after three months on the total score on neuropsychiatric symptoms. The intervention group had less apathy at 3 months follow-up compared to those receiving care as usual. The findings suggest that a more comprehensive intervention is needed to improve the total Neuropsychiatric symptoms burden and complex symptoms.
Trial Registration:
Due to delays in the organisation, the study was registered after study start, i.e. retrospectively in Clinicaltrials.gov # NCT02790372 at https://clinicaltrials.gov/ ; Date of clinical trial registration: 03/06/2016.
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