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The PiTSTOP study: a feasibility cluster randomized trial of delirium prevention in care homes for older people.
- Source :
- Age & Ageing; Sep2016, Vol. 45 Issue 5, p651-661, 11p, 1 Diagram, 1 Graph
- Publication Year :
- 2016
-
Abstract
- Background and objectives: delirium is a distressing but potentially preventable condition common in older people in long-term care. It is associated with increased morbidity, mortality, functional decline, hospitalization and significant healthcare costs. Multicomponent interventions, addressing delirium risk factors, have been shown to reduce delirium by one-third in hospitals. It is not known whether this approach is also effective in long-term care. In previous work, we designed a bespoke delirium prevention intervention, called 'Stop Delirium!' In preparation for a definitive trial of Stop Delirium, we sought to address key aspects of trial design for the particular circumstances of care homes. Design: a cluster randomized feasibility study with an embedded process evaluation. Setting and participants: residents of 14 care homes for older people in one metropolitan district in the UK. Intervention: Stop Delirium!: a 16-month-enhanced educational package to support care home staff to address key delirium risk factors. Control homes received usual care. Measurements: we collected data to determine the following: recruitment and attrition; delirium rates and variability between homes; feasibility of measuring delirium, resource use, quality of life, hospital admissions and falls; and intervention implementation and adherence. Results: two-thirds (215) of eligible care home residents were recruited. One-month delirium prevalence was 4.0% in intervention and 7.1% in control homes. Proposed outcome measurements were feasible, although our approach appeared to underestimate delirium. Health economic evaluation was feasible using routinely collected data. Conclusion: a definitive trial of delirium prevention in long-term care is needed but will require some further design modifications and pilot work. [ABSTRACT FROM AUTHOR]
- Subjects :
- NURSING home employees
RISK of delirium
NURSING care facilities
AUDITORY perception testing
CLUSTER analysis (Statistics)
CONFIDENCE intervals
DELIRIUM
MEDICAL cooperation
NURSING home residents
PROBABILITY theory
PSYCHOLOGICAL tests
QUESTIONNAIRES
RESEARCH
RESEARCH funding
VISION testing
PILOT projects
DISABILITIES
RANDOMIZED controlled trials
HUMAN services programs
INTER-observer reliability
DATA analysis software
DESCRIPTIVE statistics
KAPLAN-Meier estimator
ODDS ratio
INTRACLASS correlation
OLD age
EDUCATION
PREVENTION
Subjects
Details
- Language :
- English
- ISSN :
- 00020729
- Volume :
- 45
- Issue :
- 5
- Database :
- Complementary Index
- Journal :
- Age & Ageing
- Publication Type :
- Academic Journal
- Accession number :
- 118239233
- Full Text :
- https://doi.org/10.1093/ageing/afw091