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Start Over Author "Vickerstaff, Victoria" Journal bmc psychiatry
2 results on '"Vickerstaff, Victoria"'

1. Clinical and cost effectiveness of staff training in the delivery of Positive Behaviour Support (PBS) for adults with intellectual disabilities, autism spectrum disorder and challenging behaviour - randomised trial.

Author

Strydom, Andre, Bosco, Alessandro, Vickerstaff, Victoria, Hunter, Rachael, the PBS study group, Poppe, Michaela, Ratti, Victoria, Hall, Ian, Crabtree, Jason, Omar, Rumana Z., Biswas, Asit, Blickwedel, Jessica, Cooper, Vivien, Crawford, Mike, and Hassiotis, Angela

Subjects
AUTISM spectrum disorders, AUTISTIC people, INTELLECTUAL disabilities, MEDICAL personnel, CHILDREN with autism spectrum disorders, COST effectiveness, BEHAVIOR disorders
Abstract

Background: Although Positive Behaviour Support (PBS) is a widely used intervention for ameliorating challenging behaviour (CB), evidence for its use in adults with intellectual disability (ID) and comorbid autism (ASD) is lacking. We report a planned subsidiary analysis of adults with both ASD and ID who participated in a randomised trial of PBS delivered by health professionals. Methods: The study was a multicentre, cluster randomised trial conducted in 23 community ID services in England, participants were randomly allocated to either the delivery of PBS (n = 11 clusters) or to treatment as usual (TAU; n = 12). One-hundred and thirteen participants (46% of all participants in the trial) had a diagnosis of ID, autism spectrum disorder and CB (ASD+); (47 allocated to the intervention arm, and 66 to the control). CB (primary outcome) was measured with the Aberrant Behaviour Checklist total score (ABC-CT). Secondary outcomes included mental health status, psychotropic medication use, health and social care costs and quality adjusted life years (QALYs) over 12 months. Results: There were no statistically significant differences in ABC-CT between ASD+ groups randomised to the two arms over 12 months (adjusted mean difference = − 2.10, 95% CI: − 11.3 7.13, p = 0.655) or other measures. The mean incremental cost of the intervention per participant was £628 (95% CI -£1004 to £2013). There was a difference of 0.039 (95% CI − 0.028 to 0.103) for QALYs and a cost per QALY gained of £16,080. Conclusions: Results suggest lack of clinical effectiveness for PBS delivered by specialist ID clinical teams. Further evidence is needed from larger trials, and development of improved interventions. Trial registration: ClinicalTrials.gov: NCT01680276. [ABSTRACT FROM AUTHOR]

Published
2020
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2. Clinical and cost effectiveness of staff training in Positive Behaviour Support (PBS) for treating challenging behaviour in adults with intellectual disability: a cluster randomised controlled trial

Author

Hassiotis, Angela, Strydom, Andre, Crawford, Mike, Hall, Ian, Omar, Rumana, Vickerstaff, Victoria, Hunter, Rachael, Crabtree, Jason, Cooper, Vivien, Biswas, Asit, Howie, William, and King, Michael

Subjects
Adult, Male, PSYCHIATRY, SCI, DISORDERS, Cost-Benefit Analysis, Health Personnel, Intellectual disability, Study Protocol, Complex intervention, PEOPLE, Behavior Therapy, Cluster Analysis, Humans, VALIDITY, METAANALYSIS, SCALE, Psychiatry, Behavioural intervention, Science & Technology, 1103 Clinical Sciences, Cluster RCT, Psychiatry and Mental health, INDIVIDUALS, Treatment Outcome, Caregivers, England, PLACEMENT, RELIABILITY, Quality of Life, Positive Behaviour Support, Challenging behaviour, Female, HEALTH, Life Sciences & Biomedicine, MENTAL-RETARDATION
Abstract

Background Many people with intellectual disability present with challenging behaviour which often has serious consequences such as the prescription of long term medication, in-patient admissions and disruption of normal daily activities. Small scale studies of Positive Behaviour Support (PBS) delivered by paid carers suggest that it reduces challenging behaviour and costs of care and improves quality of life. This study aims to investigate whether professionals training in the delivery of PBS as part of routine practice is clinically and cost effective compared to treatment as usual in community intellectual disability services. Method The study is a multi-centre cluster randomised controlled trial involving community intellectual disability services in England and service users with mild to severe intellectual disability and challenging behaviour. The teams will be randomly allocated into one of two conditions, either training and support to deliver PBS or treatment as usual. We will carry out assessments of challenging behaviour, use of services, quality of life, mental health, and family and paid carer burden at six and 12 months. We will monitor treatment fidelity and we will interview a sample of paid and family carers, service users, staff and managers about what they think of the treatment and how best we can deliver it in routine care. The main outcome is reduction in challenging behaviour at one year after randomisation. We will also carry out a health economic evaluation to examine the costs and consequences of staff training in PBS. Discussion The study findings will have significant implications for the delivery of PBS in community based services with the potential for reducing inpatient admissions and out-of-area placements for adults with intellectual disability and challenging behaviour. Trial registration This trial is registered with Clinical Trials.gov (Ref NCT01680276). Clinical Trials Unit: PRIMENT https://www.ucl.ac.uk/priment/. Electronic supplementary material The online version of this article (doi:10.1186/s12888-014-0219-6) contains supplementary material, which is available to authorized users.

Published
2014

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