Clinical trial NCT02790372: The Effect of Case Conferencing in Nursing Homes
Official title: The Effect of Comprehensive Geriatric Assessment and Case Conferencing on Neuropsychiatric Symptoms Among Patients in Norwegian Nursing Homes
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Dementia
Neurobehavioral Manifestations
Keywords: Nursing homes
Norway
Lead sponsor: Norwegian University of Science and Technology
Sponsor class: OTHER
First posted: 2016-06-03
Enrollment: 309
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

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.

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

Primary outcomes:
measure: Prevalence of neuropsychiatric symptoms measured by neuropsychiatric inventory
timeFrame: 12 months
Secondary outcomes:
measure: Depression measured by Cornell scale for depression in dementia
timeFrame: 12 months
measure: Activities in daily living measured by Physical self-maintenance scale
timeFrame: 12 months
measure: Quality of life measured by the Quality of Life in Late-Stage Dementia Scale
timeFrame: 12 months
Other outcomes:
Locations:
city: Overhalla
country: Norway
facility: Overhalla sykeheim
Study officials:
affiliation: Norwegian University of Science and Technology
name: Sigrid Nakrem, phd
role: PRINCIPAL_INVESTIGATOR
References:
citation: Nakrem S, Stensvik GT, Skjong RJ, Ostaszkiewicz J. Staff experiences with implementing a case conferencing care model in nursing homes: a focus group study. BMC Health Serv Res. 2019 Mar 27;19(1):191. doi: 10.1186/s12913-019-4034-0.
citation: Stensvik GT, Helvik AS, Haugan G, Steinsbekk A, Salvesen O, Nakrem S. The short-term effect of a modified comprehensive geriatric assessment and regularly case conferencing on neuropsychiatric symptoms in nursing homes: a cluster randomized trial. BMC Geriatr. 2022 Apr 11;22(1):316. doi: 10.1186/s12877-022-02976-x.