Effects of a Dementia-friendly Program

NCT04737733 | Completed

• 1 other identifier: 2018/666(REK)
• Study Type: interventional
• Target: 423
• Locations: 1 country
• Sites: 1

Brief Summary

Frail older persons with cognitive impairment are at special risk of experiencing delirium during acute hospitalisation. The purpose of this study was to investigate whether a dementia-friendly hospital program contributes to improved detection and management of patients with cognitive impairment and delirium.

Conditions

Delirium; Cognitive Impairment; Dementia

Outcome Measures

Primary Outcomes (2)

• Detection of patients with cognitive impairment

  Proportion of patients identified with cognitive impairment during the hospital stay, documented in the electronic Medical record. Difference between the control group and the intervention group. Patients were assessed with The Four Assessment Test at admission and during the stay at the participating wards. Furthermore, documentation of cognitive impairment in the electronic medical journal during the stay were assessed after discharge.

  During the stay at the participating wards, assessed from the electronical medical record within 6 months after discharge

• Management of patients with cognitive impairment and delirium

  Proportion of patients identified with cognitive impairment, delirium or at risk of delirium who has documented interventions to prevent and/or treat delirium, according to the implemented dementia-friendly program.Differences between the control group and the intervention group.

  During the stay at the participating wards, assessed from the electronical medical record within 6 months after discharge

Secondary Outcomes (8)

• Screening within 24 hours

  Within 24 hours after admission to the ward

• Use of antipsychotics, hypnotics and sedatives

  During the stay at the participating wards, assessed from the electronical medical record within 6 months after discharge

• Use of medications not recommended for the patient group

  During the stay at the participating wards, assessed from the electronical medical record within 6 months after discharge

• Departure to rehabilitation or nursing home

  Assessed from the electronical medical record, within 6 month after discharge

• Length of hospital stay

  Assessed from the electronical medical record, within 6 month after discharge

Study Arms (1)

The dementia friendly hospital program

OTHER

The dementia-friendly hospital program comprised three parts; 1) Educational program for health practitioners to increase the staff's knowledge and awareness of patients with cognitive impairment and/or delirium; 2) Screening, for early identification of cognitive impairment and delirium, using the Four Assessment Test (4AT); 3) Delirium risk factor modification and management for patients defined with potential cognitive impairment and risk of delirium, implying that risk factor modifications should be implemented in the patient's care plan. For patients with suspected delirium, the program promoted an additional delirium management plan.

Other: The dementia friendly program

Interventions

The dementia friendly program OTHER

Implementation of a systematic screening and risk modification and management plan, to identify and enhance the management of patients with cognitive impairment and risk of delirium.

The dementia friendly hospital program

Eligibility Criteria

• Age: 75 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• Patients ≥75 years
• acute admission to the cardiac or pulmonary wards.
• Patient who has given informed written consent, or proxy consent from relatives for patients who lacked cognitive capacity.

You may not qualify if:

• Readmitted patients enrolled in a previous hospital stay.
• Patients who do not have sufficient verbal function or hearing to communicate
• Patients in a coma or too ill to participate
• Patients who are isolated
• Patients who do not wish to participate or relatives who do not want the patient to participate, in the cases where the patient lacked cognitive capacity to consent.

Sponsors & Collaborators

• University Hospital, Akershus: lead

Study Sites (1)

University hospital, Akershus

Lørenskog, 1478, Norway

Location

Related Publications (1)

• Weldingh NM, Mellingsaeter MR, Hegna BW, Benth JS, Einvik G, Juliebo V, Thommessen B, Kirkevold M. Impact of a dementia-friendly program on detection and management of patients with cognitive impairment and delirium in acute-care hospital units: a controlled clinical trial design. BMC Geriatr. 2022 Mar 31;22(1):266. doi: 10.1186/s12877-022-02949-0.

  PMID: 35361136 DERIVED

MeSH Terms

Conditions

Delirium; Cognitive Dysfunction; Dementia

Condition Hierarchy (Ancestors)

Confusion; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Neurocognitive Disorders; Mental Disorders; Cognition Disorders; Brain Diseases; Central Nervous System Diseases

Study Officials

• Nina M Weldingh, Master

  University Hospital, Akershus

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Prinsipal Investigator

Model Details: A non-equivalent control group design with a historical control group

Study Record Dates

• First Submitted: January 26, 2021
• First Posted: February 4, 2021
• Study Start: November 22, 2018
• Primary Completion: March 30, 2020
• Study Completion: June 16, 2020
• Last Updated: February 4, 2021

Record last verified: 2021-01

Locations

NO (1)