Effects of a Dementia-friendly Program

University Hospital, Akershus

Status: Completed

Conditions: Delirium; Cognitive Impairment; Dementia

Treatments: Other: The dementia friendly program

Study type: Interventional

Funder types: Other

Identifiers

NCT04737733

2018/666(REK)

Details and patient eligibility

About

Frail older persons with cognitive impairment are at special risk of experiencing delirium during acute hospitalisation. The purpose of this study was to investigate whether a dementia-friendly hospital program contributes to improved detection and management of patients with cognitive impairment and delirium.

Full description

Study design This study, has a non-equivalent control group design and a historical control Group. The Control group received usual care and the experimental group received usual care plus the dementia-friendly program.

One Group received care after implementing the dementia-friendly hospital program. The study is performed at two medical wards at a large acute-care hospital in Norway. A medical pulmonary ward and a cardiac ward participated.

Data Collection:

Demographic data included age, gender, place of residence (home, adapted housing, institution), and family/relative network, and were obtained upon admission to the study.

Medical data included cause of admission, active medical diagnoses, medications and medical treatment, and were obtained both at admission and from their electronic medical records after discharge.

Cognitive Impairment and delirium were assessed with two different screening tools: the Four Assessment Test (4AT) and the Confusion Assessment Method (CAM).

For all patients with a positive 4AT (≥1) or identified cognitive impairment during their hospital stays, a thorough review of the patient's journal was conducted upon discharge to record if, in case of yes, which type of preventive or treatment measures according to the dementia-friendly program, the patients had received during their stays.

Enrollment: 423 patients

Sex: All

Ages: 75+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients ≥75 years
• acute admission to the cardiac or pulmonary wards.
• Patient who has given informed written consent, or proxy consent from relatives for patients who lacked cognitive capacity.

Exclusion criteria

• Readmitted patients enrolled in a previous hospital stay.
• Patients who do not have sufficient verbal function or hearing to communicate
• Patients in a coma or too ill to participate
• Patients who are isolated
• Patients who do not wish to participate or relatives who do not want the patient to participate, in the cases where the patient lacked cognitive capacity to consent.

Trial design

Primary purpose: Health Services Research

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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423 participants in 1 patient group

The dementia friendly hospital program

Other group

Description:

The dementia-friendly hospital program comprised three parts; 1) Educational program for health practitioners to increase the staff's knowledge and awareness of patients with cognitive impairment and/or delirium; 2) Screening, for early identification of cognitive impairment and delirium, using the Four Assessment Test (4AT); 3) Delirium risk factor modification and management for patients defined with potential cognitive impairment and risk of delirium, implying that risk factor modifications should be implemented in the patient's care plan. For patients with suspected delirium, the program promoted an additional delirium management plan.

Treatment:

Other: The dementia friendly program