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• W2896415812 abstract "Dementia Care Mapping (DCM) is a practice development tool, used internationally, for facilitating delivery of person-centred dementia care in formal care settings. Four previous exploratory controlled studies on the efficacy of DCM in care home settings, have delivered mixed results. The DCM EPIC trial, subsequently, aimed to assess the clinical effectiveness and cost effectiveness of DCM in reducing agitation in care home residents with dementia. DCM EPIC was a multi-centre, pragmatic, cluster randomised controlled trial with follow-up at 6- and 16-months, in care 50 UK care homes and 987 recruited residents (n=726 baseline, n=261 16-months) with dementia. Care homes were randomised to DCM intervention (n=31) or usual care control (n=19). Two staff members from each intervention home were asked to complete three DCM cycles following attendance at DCM training. An DCM expert supported them during the first DCM cycle. Outcomes were 1) agitation 2) other behaviours staff may find challenging to support 3) quality of life, 4) healthcare resource use including medications. A mixed-methods process evaluation was undertaken in a sub-set of 18 intervention care homes. A total of 675 residents in the cross-sectional sample with dementia were included in the primary analysis. The adjusted mean difference in CMAI score was -2.11 points (45.47 points control/ 43.35 intervention, 95% confidence interval -4.66 to 0.44, p=0.104). The sensitivity and supportive analyses indicated that there were no differences between treatment arms at 16 months. Neither were any statistically significant differences found in the closed-cohort between arms on any resident-level secondary outcomes at 6-months. DCM was also found not to be cost-effective. Intervention adherence was problematic, with only 26% of homes completing more than one DCM cycle, owing to structural barriers identified by care home managers, DCM mappers and staff. DCM is not a clinically or cost effective intervention for reducing agitation and other behaviours, improving quality of life or reducing use of as required antipsychotics and tranquilizers in people with dementia. Future research should consider using different leadership models for DCM implementation." @default.
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• W2896415812 date "2018-07-01" @default.
• W2896415812 modified "2023-09-26" @default.
• W2896415812 title "O3‐08‐06: RESULTS OF A PRAGMATIC, CLUSTER RANDOMISED, CONTROLLED TRIAL OF THE EFFECTIVENESS AND COST‐EFFECTIVENESS OF DEMENTIA CARE MAPPING (DCM) IN UK CARE HOMES (DCM EPIC TRIAL)" @default.
• W2896415812 doi "https://doi.org/10.1016/j.jalz.2018.06.2817" @default.
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