Act In case of Depression: The evaluation of a care program to improve the detection and treatment of depression in nursing homes. Study Protocol

Gerritsen, Debby L.; Smalbrugge, Martin; Teerenstra, Steven; Leontjevas, Ruslan; Adang, Eddy; Vernooij‐Dassen, Myrra; Derksen, Els; Koopmans, Raymond T.C.M.

doi:10.1186/1471-244x-11-91

Cited by 37 publications

(21 citation statements)

References 43 publications

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“…Although it might be relevant to distinguish between barriers and facilitators related to the intervention and those related to the implementation strategy, the reviewed articles rarely present their results in this manner. Furthermore, several interventions incorporate elements, such as training (Smeets et al, 2013), that are considered implementation strategies by others (Gerritsen et al, 2011). Further research could explore the added value of this distinction.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Systematic review on barriers and facilitators of complex interventions for residents with dementia in long-term care

Kormelinck

Janus

Smalbrugge

et al. 2020

Int. Psychogeriatr.

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Objectives: Psychotropic drugs are frequently and sometimes inappropriately used for the treatment of neuropsychiatric symptoms of people with dementia, despite their limited efficacy and side effects. Interventions to address neuropsychiatric symptoms and psychotropic drug use are multifactorial and often multidisciplinary. Suboptimal implementation of these complex interventions often limits their effectiveness. This systematic review provides an overview of barriers and facilitators influencing the implementation of complex interventions targeting neuropsychiatric symptoms and psychotropic drug use in long-term care. Design: To identify relevant studies, the following electronic databases were searched between 28 May and 4 June: PubMed, Web of Science, PsycINFO, Cochrane, and CINAHL. Two reviewers systematically reviewed the literature, and the quality of the included studies was assessed using the Critical Appraisal Skills Programme qualitative checklist. The frequency of barriers and facilitators was addressed, followed by deductive thematic analysis describing their positive of negative influence. The Consolidated Framework for Implementation Research guided data synthesis. Results: Fifteen studies were included, using mostly a combination of intervention types and care programs, as well as different implementation strategies. Key factors to successful implementation included strong leadership and support of champions. Also, communication and coordination between disciplines, management support, sufficient resources, and culture (e.g. openness to change) influenced implementation positively. Barriers related mostly to unstable organizations, such as renovations to facility, changes toward self-directed teams, high staff turnover, and perceived work and time pressures. Conclusions: Implementation is complex and needs to be tailored to the specific needs and characteristics of the organization in question. Champions should be carefully chosen, and the application of learned actions and knowledge into practice is expected to further improve implementation.

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Section: Strengths and Limitationsmentioning

confidence: 99%

Systematic review on barriers and facilitators of complex interventions for residents with dementia in long-term care

Kormelinck

Janus

Smalbrugge

et al. 2020

Int. Psychogeriatr.

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“…The results of an RCT on the effectiveness of the Dutch program "Act in Case of Depression" (AiD) represent one of the few records of a program for the treatment of non-demented nursing home residents with depression. Previous results show that the implementation of AiD in Dutch nursing homes led to a significant decline in the prevalence of depression and an improvement in quality of life among residents [34][35][36]. Based on the experiences gathered in the AiD program, DAVOS will develop and implement a comprehensive case management program for institutionalized long term care settings in Germany, and conduct a controlled cluster-randomized trial to evaluate it by an interdisciplinary group of experts.…”

Section: Discussionmentioning

confidence: 99%

Depression in the nursing home: a cluster-randomized stepped-wedge study to probe the effectiveness of a novel case management approach to improve treatment (the DAVOS project)

Tesky

Schall

Schulze

et al. 2019

Preprint

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Background Depression is the second most common psychiatric illness in old people. Up to 30% of nursing home residents suffer from minor or major depression. Although depressive disorders in old age can be improved and even cured with adequate therapy, they often go unnoticed in nursing home residents and remain untreated. This highlights a striking deficit in health care and might results not only in lower quality of life among those concerned but also in poor physical functioning, premature mortality and increased hospitalization rates. Methods The aim of the interdisciplinary research project DAVOS is to implement an innovative and stepped structural case management program to improve depression treatment in nursing home residents by a modularized intervention and to assess it in terms of its effectiveness. Intervention modules are in line with recommendations given by the German national treatment guidelines for depression (S3 guidelines). Ten nursing homes in Frankfurt, Germany, will participate in the project which aims to recruit a study population of N = 380. The recruitment will continue throughout the trial (open cohort). Persons (>60 years) that live in a nursing home, have no medical diagnosis of dementia and can provide their informed consent to participate are eligible for inclusion in the study. Residents with a clinical diagnosis of dementia, alcohol or substance related disorders or other serious psychiatric illnesses will be excluded. DAVOS is a controlled cluster-randomized study that employs a stepped-wedge design. Discussion Our main hypothesis is that the implementation of the intervention will lead to a decline in the prevalence of depression and a reduction in depression symptoms among the home residents. In addition, we expect the intervention to have a positive impact on secondary outcomes such as level of functioning, quality of life and social participation. The project’s results can make an important contribution towards improving the health care of nursing home residents suffering from late-life depression.

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“…La CSDD tiene 19 ítems, con una puntuación total máxima de 38, y un punto de corte de 7/8 para sintomatología depresiva significativa [25][26][27] .…”

Section: Sujetos Y Métodosunclassified

“…Los valores ≥0,60 fueron considerados altos, de 0,40 a0,59 moderados y de 0,20 a 0,39 débiles 28 . Además, la muestra se dividió en grupos por las siguientes variables: sexo, edad (60-85 y 86 y más), nivel educativo (sin estudios o primarios incompletos versus con estudios primarios o más), por estado civil, por número de problemas de salud crónicos (según la mediana: ≤7 y >7) y por el punto de corte de la CSDD (7/8) [25][26][27] . Se analizó si las puntuaciones de las escalas EQ-5D (índice y EVA) y QoL-AD presentaban diferencias significativas en función de los grupos anteriormente descritos mediante tests t de Student.…”

Section: Sujetos Y Métodosunclassified

Calidad de vida y estado de salud en personas mayores de 60 años con demencia institucionalizadas

Rodríguez‐Blázquez

Martín-García²,

Frades-Payo

et al. 2015

Rev. Esp. Salud Publica

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Act In case of Depression: The evaluation of a care program to improve the detection and treatment of depression in nursing homes. Study Protocol

Cited by 37 publications

References 43 publications

Systematic review on barriers and facilitators of complex interventions for residents with dementia in long-term care

Systematic review on barriers and facilitators of complex interventions for residents with dementia in long-term care

Depression in the nursing home: a cluster-randomized stepped-wedge study to probe the effectiveness of a novel case management approach to improve treatment (the DAVOS project)

Calidad de vida y estado de salud en personas mayores de 60 años con demencia institucionalizadas

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