Journal of the American Medical Directors Association
Original StudyComing to Grips With Challenging Behavior: A Cluster Randomized Controlled Trial on the Effects of a Multidisciplinary Care Program for Challenging Behavior in Dementia
Section snippets
Ethics
The full trial protocol has been published elsewhere.29 The study protocol is in accordance with the declaration of Helsinki and with the Dutch legislation on medical research; it is in agreement with the Conduct Health Research of the Dutch federation of Biomedical Scientific Societies. The study protocol was approved by the Medical Ethics Review Committee of the VU University Medical Centre. The committee stated that, in accordance with Dutch legislation, the study can be performed without a
Results
Of the 22 organizations that originally showed interest in participation, 5 decided not to take part. Four of these organizations declined because of organizational changes in the near future, and 1 organization had planned to introduce their own new approach for the management of behavioral problems. One unit that did participate moved to another location after T3. Only data from T0–T3 were used in this study for this DSCU.
Of the 17 participating organizations, 9 were affiliated with 1 of the
Discussion
The aim of this study was to determine the effect of using the Grip on Challenging Behavior care program on the prevalence of challenging behavior and on the use of psychoactive medication and restraints. The care program was implemented in 17 DSCUs and challenging behavior and the use of psychoactive medication and restraints was measured over a 20-month period. A significant decrease of challenging behavior, measured as differences in total CMAI score between subsequent measurements, was
Conclusions
A small but significant decrease in prevalence of challenging behavior was found after implementation of the Grip on Challenging Behavior program. The program considerably diminished the use of psychoactive drugs, especially antipsychotics and antidepressants, whereas no difference in restraint use was found.
Acknowledgments
The authors would like to thank all involved organizations, their care staff, and their residents for participating.
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This study was funded by the Netherlands Organization for Health Research and Development (ZonMw). The authors have not entered into an agreement with the funding organization that has limited their ability to complete the research as planned and publish the results. The authors received no further support from any organization for the submitted work; the authors have no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years, and the authors have no other relationships or activities that could appear to have influenced the submitted work.