The Effect of Case Conferencing in Nursing Homes

Study Overview
=================
Brief Summary
-----------------
This study evaluates the effect of using comprehensive geriatric assessment in combination with case conferences on the prevalence of neuropsychiatric symptoms (also known as behavioral and psychological symptoms of dementia) in Norwegian nursing homes

Detailed Description
-----------------
Long-term care patients in nursing homes (NH) are characterized by frailty and having multiple health problems and reduced quality of life. Some of these issues relates to the quality of care and do therefore possess a potential for improvement. There is a need for approaches enabling nurses to carry out effective interventions that can promote health related to sustain or improve the nursing home patients health status. Integrating a comprehensive geriatric assessment (CGA) and case conferencing (CC) might be an effective method to individualize care plans in order to improve quality of care. The intervention nursing homes will implement CGA, using the International resident instrument suite for Long Term Care Facilities (InterRai LTCF) and CC. The patients will be included and assessed three times during a 12-month period (control and intervention NHs). In the intervention NHs the results from the CGA will be reviewed in monthly CCs. The CCs are structured and consist of four main steps; evaluating the effects of earlier interventions, defining patients risks or area for improvement, defining the aetiology of the risk or problem, defining interventions and measures for improvement along with an appropriate method for evaluation. The CC group's consensus is basis for the patient's care plan.

Official Title
-----------------
The Effect of Comprehensive Geriatric Assessment and Case Conferencing on Neuropsychiatric Symptoms Among Patients in Norwegian Nursing Homes

Conditions
-----------------
Dementia, Neurobehavioral Manifestations

Intervention / Treatment
-----------------
* Other: Case conferencing


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: registered as long term care patient been in the nursing home for more than a month Informed consent from the patient or legal guardians Exclusion Criteria: life expectancy less than six months

Ages Eligible for Study
-----------------
Minimum Age: 65 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control nursing homes<br>Nursing homes carries out usual care | |
| Active Comparator: Intervention nursing homes<br>Nursing homes that carries out regularly case conferencing | Other: Case conferencing<br>* Intervention nursing homes carries out regularly case conferencing based on comprehensive geriatric assessments. Case conferencing is carried out each month for nursing home patients included in the study<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prevalence of neuropsychiatric symptoms measured by neuropsychiatric inventory | Measured by neuropsychiatric inventory | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Depression measured by Cornell scale for depression in dementia | Measured by Cornell scale for depression in dementia | 12 months | 
| Activities in daily living measured by Physical self-maintenance scale | Measured by Physical self-maintenance scale | 12 months | 
| Quality of life measured by the Quality of Life in Late-Stage Dementia Scale | Measured by the Quality of Life in Late-Stage Dementia Scale | 12 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Nursing homes, Norway