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• W2897968995 abstract "Neuropsychiatric symptoms (NPS) such as agitation are a core, prevalent and persistent feature of Alzheimer's disease and related dementias. NPS are particularly problematic during hospitalization, placing patients at increased risk for a range of adverse and costly outcomes. Despite clear guidelines recommending non-pharmacologic approaches as first-line therapy for NPS, these are under-utilized in the hospital setting. This gap is exacerbated by a lack of feasible hospital-based interventions to help clinicians determine and address the underlying causes of NPS. Our aim was to develop, implement and evaluate the PeRsOnalized ApproaCh and Targeted InterVEntions (PROACTIVE) Treatment Protocol, a multi-component decision support protocol and intervention designed to address the specific work-process and system challenges of acute care with the goals of improving use of evidence-based treatment responses and reducing stress/burden among staff. Work system mapping techniques were employed to design a detailed, systematic treatment protocol including documentation templates, physical environment reminders and built-in intervention resources. We conducted a matched-sample pre-post implementation study to determine the feasibility/acceptability of PROACTIVE and obtain preliminary estimates of its impact on use of non-pharmacologic treatment responses, staff confidence and stress/burden. Patient characteristics and treatment responses were abstracted from the medical record for all eligible dementia patients during the 6 months prior to the pilot intervention launch and for patients enrolled in the 6-month pilot. The PROACTIVE Treatment Protocol incorporates four integrated care processes: individualized needs assessment, prevention strategies, systematic pain assessment/treatment algorithm and symptom-specific treatment guidance. Over a 6-month period, 28 patients were enrolled in the treatment protocol. Nursing staff delivered 47 non-pharmacologic symptom-specific treatment responses, 67% of which were deemed effective on first treatment cycles. Nursing teams reported feeling more supported and comfortable in responding to NPS. Key implementation challenges include the need for ongoing staff training, feedback on progress and changes in staffing. PROACTIVE was successfully designed and piloted by a research and clinical team, and has been effective in increasing comfort in AD symptom management. Future steps include ongoing implementation and evaluation of patient-level metrics." @default.
• W2897968995 created "2018-10-26" @default.
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• W2897968995 date "2018-07-01" @default.
• W2897968995 modified "2023-10-16" @default.
• W2897968995 title "P4‐138: PILOT TESTING OF A CLINICAL INTERVENTION FOR NEUROPSYCHIATRIC SYMPTOM MANAGEMENT IN HOSPITALIZED PATIENTS WITH ALZHEIMER'S AND RELATED DEMENTIAS" @default.
• W2897968995 doi "https://doi.org/10.1016/j.jalz.2018.06.2542" @default.
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