Top

Published in:

Open Access 01-12-2022 | Care | Study protocol

Achieving Quality and Effectiveness in Dementia Using Crisis Teams (AQUEDUCT): a study protocol for a randomised controlled trial of a Resource Kit

Authors: Donna Maria Coleston-Shields, David Challis, Angela Worden, Emma Broome, Tom Dening, Boliang Guo, Juanita Hoe, Brynmor Lloyd-Evans, Esme Moniz-Cook, Steve Morris, Fiona Poland, David Prothero, Martin Orrell

Published in: Trials | Issue 1/2022

Abstract

Background

Improving care at home for people with dementia is a core policy goal in the dementia strategies of many European countries. A challenge to effective home support is the occurrence of crises in the care of people with dementia which arise from changes in their health and social circumstances. Improving the management of these crises may prevent hospital admissions and facilitate better and longer care at home. This trial is part of a National Institute for Health Research funded programme, AQUEDUCT, which aims to improve the quality and effectiveness of teams working to manage crises in dementia.

Methods/design

It is a pragmatic randomised controlled trial of an online Resource Kit to enhance practice in teams managing crises in dementia care. Thirty teams managing mental health crises in dementia in community settings will be randomised between the Resource Kit intervention and treatment as usual. The primary outcome measure is psychiatric admissions to hospital for people with dementia in the teams’ catchment area recorded 6 months after randomisation. Other outcomes include quality of life measures for people with dementia and their carers, practitioner impact measures, acute hospital admissions and costs. To enhance understanding of the Resource Kit intervention, qualitative work will explore staff, patient and carers’ experience.

Discussion

The Resource Kit intervention reflects current policy to enable home-based care for people with dementia by addressing the management of crises which threaten the viability of care at home. It is based upon a model of best practice for managing crises in dementia designed to enhance the quality of care, developed in partnership with people with dementia, carers and practitioners. If the Resource Kit is shown to be clinically and cost-effective in this study, this will enhance the probability of its incorporation into mainstream practice.

Trial registration

ISRCTN 42855694; Registered on 04/03/2021; Protocol number: 127686/2020v9; Research Ethics Committee, 09/03/2021, Ref 21/WM/0004; IRAS ID: 289982

Available only for authorised users

Prince M, Wimo A, Guerchet M, Ali GC, Wu YT, Prina M. Alzheimer’s Disease International. World Alzheimer Report 2015. In: The global impact of dementia: an analysis of prevalence, incidence, cost and trends. London: Alzheimer’s Disease International; 2015. https://www.alz.co.uk/research/WorldAlzheimerReport2015.pdf. Accessed 21 May 2021.

Prince M, Knapp M, Guerchet M, McCrone P, Prina M, Comas-Herrera M, et al. Dementia UK: Update. London: Alzheimer’s Society; 2014. https://www.alzheimers.org.uk/sites/default/files/migrate/downloads/dementia_uk_update.pdf. Accessed 21 May 2021

Department of Health. The Prime Ministers Challenge on Dementia: Delivering Major Improvements in Dementia Care and Research by 2015. London: Department of Health; 2012. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/215101/dh_133176.pdf. Accessed 21 May 2021

Department of Health. Prime Minister’s Challenge on Dementia 2020: Implementation Plan. London: Department of Health; 2016. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/507981/PM_Dementia-main_acc.pdf. Accessed 20 May 2021

Department of Health. Living Well with Dementia: A National Dementia Strategy. London: TSO; 2009. https://www.gov.uk/government/publications/living-well-with-dementia-a-national-dementia-strategy. Accessed 21 May 2021

Johnson S, Nolan F, Hoult J, White IR, Bebbington P, Sandor A, et al. Outcomes of crises before and after introduction of a crisis resolution team. Brit J Psychiat. 2005;187(1):68–75. https://doi.org/10.1192/bjp.187.1.68.CrossRefPubMed

Johnson S, Nolan F, Pilling S, Sandor A, Hoult J, McKenzie N, et al. Randomised controlled trial of acute mental health care by a crisis resolution team: the north Islington crisis study. BMJ. 2005;331(7517):599. https://doi.org/10.1136/bmj.38519.678148.8F.CrossRefPubMedPubMedCentral

Glover G, Arts G, Suresh BK. Crisis resolution/home treatment teams and psychiatric admission rates in England. Br J Psychiatry. 2006;189(5):441–5. https://doi.org/10.1192/bjp.bp.105.020362.CrossRefPubMed

Jethwa K, Galappathie N, Hewson P. Effects of a crisis resolution and home treatment team on in-patient admissions. Psychiatr Bull. 2007;31(5):170–2. https://doi.org/10.1192/pb.bp.106.010389.CrossRef

10.

Tyrer P, Gordon F, Nourmand S, Lawrence M, Curran C, Southgate D, et al. Controlled comparison of two crisis resolution and home treatment teams. The Psychiatrist. 2010;34(2):50–4. https://doi.org/10.1192/pb.bp.108.023077.CrossRef

11.

Wheeler C, Lloyd-Evans B, Churchard A, Fitzgerald C, Fullarton K, Mosse L, et al. Implementation of the Crisis Resolution Team model in adult mental health settings: a systematic review. BMC Psychiatry. 2015;15(1):74. https://doi.org/10.1186/s12888-015-0441-x.CrossRefPubMedPubMedCentral

12.

Streater A, Coleston-Shields DM, Yates J, Stanyon M, Orrell M. A scoping review of crisis teams managing dementia in older people. Clin Interv Aging. 2017;12:1589–603. https://doi.org/10.2147/CIA.S142341.CrossRefPubMedPubMedCentral

13.

Joint Commissioning Panel for Mental Health. Guidance for commissioners of older people’s mental health services. London: Joint Commissioning Panel for Mental Health; 2013. https://www.slideshare.net/jcpmh/jcpmh-olderpeopleguide. Accessed 21 May 2021

14.

Yates J, Stanyon M, Challis D, Coleston-Shields DM, Dening T, Hoe J, et al. Developing a model of best practice for teams managing crisis in people with dementia: a consensus approach. BMC Psychiatry. 2020;20(1):505. https://doi.org/10.1186/s12888-020-02899-0.CrossRefPubMedPubMedCentral

15.

Toot S, Hoe J, Ledgerd R, Burnell K, Devine M, Orrell M. Causes of crises and appropriate interventions: the views of people with dementia, carers and healthcare professionals. Aging Ment Health. 2013;17(3):328–35. https://doi.org/10.1080/13607863.2012.732037.CrossRefPubMed

16.

Orrell M, Hoe J, Charlesworth G, Russell I, Challis D, Moniz-Cook E, et al. Support at Home: Interventions to Enhance Life in Dementia (SHIELD) evidence, development and evaluation of complex interventions. Program Grants Appl Res. 2017;5(5). https://doi.org/10.3310/pgfar05050

17.

Dibben C, Saeed H, Stagias K, Khandaker G, Rubinsztein J. Crisis resolution and home treatment teams for older people with mental illness. Psychiatr Bull. 2008;32(7):268–70. https://doi.org/10.1192/pb.bp.107.018218.CrossRef

18.

Cooper C, Regan C, Tandy A, Johnson S, Livingston G. Acute mental health care for older people by crisis resolution teams in England. Int J Geriatr Psychiatry. 2007;22(3):263–5. https://doi.org/10.1002/gps.1650.CrossRefPubMed

19.

Toot S, Devine M, Orrell M. The effectiveness of crisis resolution/home treatment teams for older people with mental health problems: a systematic review and scoping exercise. Int J Geriatr Psychiatry. 2011;26(12):1221–30. https://doi.org/10.1002/gps.2686.CrossRefPubMed

20.

Stanyon M, Streater A, Coleston-Shields DM, Yates J, Challis D, Dening T, et al. Development of an Evidence-Based Best Practice Model for Teams Managing Crisis in Dementia: Protocol for a Qualitative Study. JMIR Res Protoc. 2021;10(1):e14781. https://doi.org/10.2196/14781.CrossRefPubMedPubMedCentral

21.

Chan A-W, Tetzlaff JM, Gøtzsche PC, Altman DG, Mann H, Berlin J, et al. SPIRIT 2013 Explanation and Elaboration: Guidance for protocols of clinical trials. BMJ. 2013;346:e7586. https://doi.org/10.1136/bmj.e7586.CrossRefPubMedPubMedCentral

22.

EMA. Guideline on Data Monitoring Committees. London: European Medicines Agency; 2005. https://www.ema.europa.eu/en/documents/scientific-guideline/guideline-data-monitoring-committees_en.pdf Accessed 21 May 2021

23.

Broome E, Coleston-Shields D, Dening T, Moniz-Cook E, Poland F, Stanyon M, et al. AQUEDUCT Intervention for Crisis Team Quality and Effectiveness in Dementia: Protocol for a Feasibility Study. JMIR Res Protoc. 2020;9(10):e18971. https://doi.org/10.2196/18971.CrossRefPubMedPubMedCentral

24.

House of Commons. Mental Capacity Act 2005. Chapter 9. London: House of Commons; 2005. https://www.legislation.gov.uk/ukpga/2005/9/pdfs/ukpga_20050009_en.pdf. Accessed 21 May 2021

25.

Attkisson CC, Zwick R. The client satisfaction questionnaire. Psychometric properties and correlations with service utilization and psychotherapy outcomes. Eval Program Plann. 1982;5(3):233–7. https://doi.org/10.1016/0149-7189(82)90074-X.CrossRefPubMed

26.

Janssen MF, Pickard AS, Golicki D, Gudex C, Niewada M, Scalone L, et al. Measurement properties of the EQ-5D-5 L compared to the EQ-5D-3L across eight patient groups: a multi-country study. Qual Life Res. 2013;22(7):1717–27. https://doi.org/10.1007/s11136-012-0322-4.CrossRefPubMed

27.

EuroQol. EQ-5D-5 L. Rotterdam: EuroQol Research Foundation; 2021. https://euroqol.org/eq-5d-instruments/eq-5d-5l-about/. Accessed 8 April 2021

28.

Goldberg D, Williams P. A User's Guide to the General Health Questionnaire. Windsor: NFER-Nelson; 1988.

29.

Bond FW, Lloyd J, Guenole N. The work-related acceptance and action questionnaire (WAAQ): Initial psychometric findings and their implications for measuring psychological flexibility in specific contexts. J Occup Organ Psychol. 2013;86(3):331–47. https://doi.org/10.1111/joop.12001.CrossRef

30.

Schaufeli WB, Salanova M, Gonzalez-Roma V, Bakker AB. The measurement of engagement and burnout: A confirmatory factor analytic approach. J Happiness Stud. 2002;3(1):71–92. https://doi.org/10.1023/A:1015630930326.CrossRef

31.

Schaufeli WB, Bakker AB. UWES: Utrecht Work Engagement Scale: Preliminary Manual. Utrecht: Occupational Health Psychology Unit, Utrecht University; 2004. https://www.wilmarschaufeli.nl/publications/Schaufeli/Test%20Manuals/Test_manual_UWES_English.pdf. Accessed 8 April 2021

32.

Knapp M, Beecham J. Reduced list costings: examination of an informed short cut in mental health research. Health Econ. 1993;2(4):313–33. https://doi.org/10.1002/hec.4730020404.CrossRefPubMed

33.

Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap) – A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81. https://doi.org/10.1016/j.jbi.2008.08.010.CrossRefPubMed

34.

Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O’Neal L, et al. The REDCap consortium: Building an international community of community of software partners. J Biomed Inform. 2019;95:103208. https://doi.org/10.1016/j.jbi.2019.103208.CrossRefPubMedPubMedCentral

35.

EMA. Guidelines on adjustment for baseline covariates. London: European Medicines Agency; 2015. https://www.ema.europa.eu/en/documents/scientific-guideline/guideline-adjustment-baseline-covariates-clinical-trials_en.pdf. Accessed 20 May 2021

36.

Vickers AJ, Altman DG. Analysing controlled trials with baseline and follow up measurements. BMJ. 2001;323(7321):1123–4. https://doi.org/10.1136/bmj.323.7321.1123.CrossRefPubMedPubMedCentral

37.

Guest G, Namey E, Chen M. A simple method to assess and report thematic saturation in qualitative research. PLoS One. 2020;15(5):e0232076. https://doi.org/10.1371/journal.pone.0232076.CrossRefPubMedPubMedCentral

38.

Department of Health. Prime Minister’s challenge on dementia 2020. London: Department of Health; 2015. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/414344/pm-dementia2020.pdf. Accessed 20 May 2021

Title: Achieving Quality and Effectiveness in Dementia Using Crisis Teams (AQUEDUCT): a study protocol for a randomised controlled trial of a Resource Kit
Authors: Donna Maria Coleston-Shields
David Challis
Angela Worden
Emma Broome
Tom Dening
Boliang Guo
Juanita Hoe
Brynmor Lloyd-Evans
Esme Moniz-Cook
Steve Morris
Fiona Poland
David Prothero
Martin Orrell
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Care
Dementia
Dementia
Published in: Trials / Issue 1/2022
Electronic ISSN: 1745-6215
DOI: https://doi.org/10.1186/s13063-021-05995-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Achieving Quality and Effectiveness in Dementia Using Crisis Teams (AQUEDUCT): a study protocol for a randomised controlled trial of a Resource Kit

Abstract

Background

Methods/design

Discussion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods/design

Discussion

Trial registration

Please log in to get access to this content

Other articles of this Issue 1/2022

Pre-incisional infiltration with ropivacaine plus dexamethasone palmitate emulsion for postoperative pain in patients undergoing craniotomy: study protocol for a prospective, randomized controlled trial

Correction: Prophylaxis in healthcare workers during a pandemic: a model for a multi-centre international randomised controlled trial using Bayesian analyses

Statistical analysis plan for the OPTIMUM study: optimising immunisation using mixed schedules, an adaptive randomised controlled trial of a mixed whole-cell/acellular pertussis vaccine schedule

Development of a core outcome set for hypertensive intracerebral hemorrhage in clinical trials of traditional Chinese medicine: a study protocol

Impact of emergency physician-performed ultrasound for the evaluation of patients with acute abdominal pain, prospective randomized dual Centre study: study protocol for a diagnostic trial

Internet-based vestibular rehabilitation versus standard care after acute onset vertigo: a study protocol for a randomized controlled trial