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Introduction of a management toolkit for Lewy body dementia : a pilot cluster randomised trial
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O'Brien, John T., McKeith, Ian G., Thomas , Alan J., Bamford, Claire, Vale, Luke, Hill, Sarah, Allan, Louise, Finch, Tracy, McNally, Richard, Hayes, Louise, Surendranathan, Ajenthan, Kane, Joseph P. M., Dunn, Sarah, Bentley, Allison, Barker, Sally, Mason, James, Burn, David and Taylor , John-Paul (2020) Introduction of a management toolkit for Lewy body dementia : a pilot cluster randomised trial. Movement Disorders . doi:10.1002/mds.28282 (In Press)
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Official URL: https://doi.org/10.1002/mds.28282
Abstract
Background
Lewy body dementia, comprising both dementia with Lewy bodies and Parkinson's disease dementia, is challenging to manage because of a complex symptom profile and lack of clear evidence‐based management guidelines.
Objectives
We assessed the feasibility of undertaking a cluster randomized study of the introduction of an evidence‐based management toolkit for Lewy body dementia, assessing the outcomes for patients and carers as secondary measures.
Methods
We randomized 23 memory/dementia, movement disorder, or nonspecialist secondary care services to the management toolkit or usual care. People with dementia with Lewy bodies or Parkinson's disease dementia underwent assessments of cognition, motor and neuropsychiatric symptoms, and global outcome at baseline and 3 and 6 months. Healthcare, personal and social care costs, and carer‐related outcomes of carer stress, depression, and anxiety were also examined.
Results
A total of 131 participants were recruited (target 120), for whom 6‐month data were available on 108 (83%). There was a benefit of being in the intervention arm for carers (reduced Zarit Burden Scale [P < 0.01], reduced depressive symptoms [P < 0.05]), who also reported less marked patient deterioration on the global outcome measure (P < 0.05). There were no significant differences in other outcomes or in costs between groups.
Conclusions
The introduction of an evidence‐based management toolkit for Lewy body dementia was feasible and associated with some benefits, especially for carers. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC. on behalf of International Parkinson and Movement Disorder Society.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > R Medicine (General) R Medicine > RC Internal medicine |
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| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Lewy body dementia , Clinical trials, Parkinson's disease , Nervous system -- Degeneration | ||||||
| Journal or Publication Title: | Movement Disorders | ||||||
| Publisher: | Wiley-Blackwell Publishing Ltd. | ||||||
| ISSN: | 0885-3185 | ||||||
| Official Date: | 22 September 2020 | ||||||
| Dates: |
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| Date of first compliant deposit: | 8 September 2020 | ||||||
| DOI: | 10.1002/mds.28282 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | In Press | ||||||
| Access rights to Published version: | Open Access | ||||||
| RIOXX Funder/Project Grant: |
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