Refine
Has Fulltext
- no (3) (remove)
Document Type
- Article (3)
Is part of the Bibliography
- yes (3)
Keywords
- guideline (3) (remove)
Institute
Objective: To test the effect of a complex guideline-based intervention on agitation and psychotropic prescriptions.
Design, Setting, Participants: Cluster randomized controlled trial (VIDEANT) with blinded assessment of outcome in 18 nursing homes in Berlin, Germany, comprising 304 dementia patients.
Intervention: Training, support, and activity therapy intervention, delivered at the level of each nursing home, focusing on the management of agitation in dementia. Control group nursing homes received treatment as usual.
Measurements: Levels of agitated and disruptive behavior (Cohen-Mansfield agitation inventory [CMAI]) as the primary outcome. Number of neuroleptics, antidepressants, and cholinesterase inhibitors (ChEIs) prescribed in defined daily dosages (DDDs).
Results: Of 326 patients screened, 304 (93.3%) were eligible and cluster-randomized to 9 intervention (n = 163) and 9 control (n = 141) nursing homes. Data were collected from 287 (94.4%) patients at 10 months. At 10 months, compared with controls, nursing home residents with dementia in the intervention group exhibited significantly less agitation as measured with the CMAI (adjusted mean difference, 6.24; 95% CI 2.03-14.14; P = .009; Cohen's d = 0.43), received fewer neuroleptics (P < .05), more ChEIs (P < .05), and more antidepressants (P < .05).
Conclusion: Complex guideline-based interventions are effective in reducing agitated and disruptive behavior in nursing home residents with dementia. At the same time, increased prescription of ChEIs and antidepressants together with decreased neuroleptic prescription suggests an effect toward guideline-based pharmacotherapy.
Zur Abschaffung des Gutachterverfahrens in der Vertragspsychotherapie – ein Qualitätsverlust?
(2021)
Zielsetzung: Der vorliegende Artikel befasst sich mit der Fragestellung, inwiefern das Gutachterverfahren in der Vertragspsychotherapie ein zuverlässiges Qualitätsinstrument darstellt und ob sich aus der geplanten Abschaffung des Gutachterverfahrens das Risiko einer Qualitätsminderung in der ambulanten Psychotherapie ergibt.
Methodik: Es wurde eine Literaturrecherche durchgeführt. Arbeiten von den Jahren 2000 bis 2020 wurden berücksichtigt, welche sich mit dem Gutachterverfahren als Qualitätsmerkmal der ambulanten Psychotherapie befassen. Um die unterschiedlichen Standpunkte der zitierten Autor_innen zu diskutieren, wurde auch Bezug auf weiterführende Literatur genommen.
Ergebnisse: Das Gutachterverfahren scheint empirisch nicht sicher als zuverlässiges Qualitätsmerkmal der ambulanten Psychotherapie herangezogen werden zu können. Die Annahme, dass sich durch eine gutachterbefreite Vertragspsychotherapie eine Qualitätsminderung der Psychotherapie ergibt, wird durch die hier zusammengefassten Arbeiten insgesamt nicht gestützt.
Background: Child growth is a dynamic process. When measured at short intervals, children’s growth shows characteristic patterns that can be of great importance for clinical purposes.
Objective: To study whether measuring height on a daily basis using an APP is practicable and user-friendly.
Methods: Recruitment took place via Snowball Sampling. Thirteen out of 14 contacted families signed up for a study period of 12 weeks with altogether 22 healthy children aged 3 to 13 years (response rate 93%). The study started with a visit to the family home for the setup of the measurement site, conventional height measuring and initial training of the new measurement process. Follow-up appointments were made at four, eight and 12 weeks. The children’s height was measured at daily intervals at their family homes over a period of three months.
Results: The parents altogether recorded 1704 height measurements and meticulously documented practicability and problems when using the device.
A 93% response rate in recruitment was achieved by maintaining a high motivation within the families. Contact with the principal investigator was permanently available, including open communication, personal training and attendance during the appointments at the family homes.
Conclusion: Measuring height by photographic display is interesting for children and parents and can be used for height measurements at home. A positive response rate of 13 out of 14 families with altogether 22 children highlights feasible recruitment and the high convenience and user-friendliness of daily APP-supported height measurements. Daily APP measurements appear to be a promising new tool for longitudinal growth studies.