Pragmatic Trial of Personalized Music for Agitation and Antipsychotic Use in Nursing Home Residents With Dementia.
Pragmatic Trial of Personalized Music for Agitation and Antipsychotic Use in Nursing Home Residents With Dementia.
复制标题
个性化音乐用于老年痴呆症疗养院居民的激越和抗精神病药物使用的实用性试验。
DOI：
10.1016/j.jamda.2021.12.030
复制
发表时间：
2022-07
影响因子：
7.6
通讯作者：
Mor V
中科院分区：
文献类型：
--
作者：
McCreedy EM;Sisti A;Gutman R;Dionne L;Rudolph JL;Baier R;Thomas KS;Olson MB;Zediker EE;Uth R;Shield RR;Mor V
目的：测试个性化音乐干预对长期入住养老院的痴呆症患者激越行为和用药的影响。个性化音乐干预的务实、整群随机对照试验。干预设施的工作人员识别了居民的早期音乐偏好，并在情绪激动的早期迹象或通常发生的破坏性行为时提供音乐。控制设施中的常规护理可能包括环境音乐或集体音乐。这项研究于2019年6月至2020年2月在4家公司拥有的10个州的54家养老院(27家干预和27家对照)进行。对每个住院医生的四个月结果进行了测量。主要结果是使用科恩-曼斯菲尔德激动量表进行激越行为的频率。次要结果包括在最小数据集中报告的激动行为的频率，以及使用抗精神病药物、抗抑郁药物或抗焦虑药物的居民比例。这项研究包括976名患有痴呆症的居民(483名治疗组和493名对照组；平均年龄=80.3岁(12.3岁)，69%是女性，25%是非裔美国人)。两组CMAI分比较差异无统计学意义(治疗组：5 0.6 7；标准差，SE=1.94；对照组：49.34；SE=1.68)(平均边际效应：AME=1.33；SE=1.38；95%CI，−=1.3 7~4.0 3)。基于精神疾病的行为评分也没有显著差异(治疗组：0.35；SE0.13与对照组：0.46；SE0.11)(AME，−0.11；SE，0.10；95%CI，−0.30至0.08)。在过去的一周里，干预设施中使用抗精神病药物的居民比对照组少(治疗：26.2；SE1.4与对照组：29.6；SE1.3)(AME，−3.61；SE，1.85；95%CI，−7.22至0.00)，但这一指标和其他精神药物使用指标都没有统计学意义。个性化音乐在减少长期居住的痴呆症患者的激动行为和精神药物使用方面并不显著。全面实施的障碍包括聘用一线护理人员和确定居民首选的音乐。在这项在54家养老院和976名痴呆症患者中进行的现实世界试验中，个性化的音乐并没有影响焦虑行为的频率或接受精神药物的治疗。
To test the effect of a personalized music intervention on agitated behaviors and medication use among long-stay nursing home residents with dementia. Pragmatic, cluster-randomized controlled trial of a personalized music intervention. Staff in intervention facilities identified residents’ early music preferences and offered music at early signs of agitation or when disruptive behaviors typically occur. Usual care in control facilities may include ambient or group music. The study was conducted between June, 2019 and February, 2020 at 54 nursing homes (27 intervention and 27 control) in 10 states owned by 4 corporations. Four-month outcomes were measured for each resident. The primary outcome was frequency of agitated behaviors using the Cohen-Mansfield Agitation Inventory. Secondary outcomes included frequency of agitated behaviors reported in the Minimum Data Set, and the proportion of residents using antipsychotic, antidepressant, or anti-anxiety medications. The study included 976 residents with dementia (483 treatment and 493 control; mean age = 80.3 (12.3), 69% female, 25% African American). CMAI scores were not significantly different (treatment: 50.67; standard error, SE, 1.94 vs control: 49.34; SE 1.68) (average marginal effect, AME, 1.33; SE, 1.38; 95% CI, −1.37 to 4.03). MDS based behavior scores were also not significantly different (treatment: 0.35; SE 0.13 vs control: 0.46; SE 0.11) (AME, −0.11; SE, 0.10; 95% CI, −0.30 to 0.08). Fewer residents in intervention facilities used antipsychotics in the past week compared to controls (treatment: 26.2; SE 1.4 vs control: 29.6; SE 1.3) (AME, −3.61; SE, 1.85; 95% CI, −7.22 to 0.00) but neither this nor other measures of psychotropic drug use were statistically significant. Personalized music was not significantly effective in reducing agitated behaviors nor psychotropic drug use among long-stay residents with dementia. Barriers to full implementation included engaging frontline nursing staff and identifying resident preferred music. In this real-world trial conducted in 54 nursing homes with 976 residents with dementia, personalized music did not affect the frequency of agitated behaviors or receipt of psychotropic medications.
登录
查看更多内容
DOI：
10.1016/j.jamda.2020.05.039
发表时间：
2020-11
影响因子：
7.6
作者：
Gerlach LB;Kales HC;Kim HM;Bynum JPW;Chiang C;Strominger J;Maust DT
通讯作者：
Maust DT
DOI：
10.1016/j.jamda.2020.01.103
发表时间：
2020-08
影响因子：
7.6
作者：
Bakerjian D;Bettega K;Cachu AM;Azzis L;Taylor S
通讯作者：
Taylor S
影响因子：
1.3
作者：
Gerdner, Linda A.;Schoenfelder, Deborah Perry
通讯作者：
Schoenfelder, Deborah Perry
影响因子：
6.3
作者：
Largent, Emily A.;Hey, Spencer Phillips;Karlawish, Jason
通讯作者：
Karlawish, Jason
DOI：
10.1016/j.jamda.2019.08.030
发表时间：
2019-12-01
影响因子：
7.6
作者：
McCreedy, Ellen;Ogarek, Jessica A.;Mor, Vincent
通讯作者：
Mor, Vincent