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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 (2021) Introduction of a management toolkit for Lewy body dementia : a pilot cluster randomised trial. Movement Disorders, 36 (1). pp. 143-151. doi:10.1002/mds.28282

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Official URL: https://doi.org/10.1002/mds.28282

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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
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine
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
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: January 2021
Dates:
DateEvent
January 2021Published
22 September 2020Available
1 September 2020Accepted
Volume: 36
Number: 1
Page Range: pp. 143-151
DOI: 10.1002/mds.28282
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
DTC-RP-PG-0311-12001[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
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