Journal
INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY
Volume 32, Issue 10, Pages 1094-1103Publisher
WILEY
DOI: 10.1002/gps.4572
Keywords
dementia; care homes; antipsychotic review; psychosocial; quality of life
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Funding
- National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme [RP-PG-0608-10133]
- National Institute for Health Research [RP-PG-0608-10133] Funding Source: researchfish
- National Institutes of Health Research (NIHR) [RP-PG-0608-10133] Funding Source: National Institutes of Health Research (NIHR)
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BackgroundVery few interventional studies have directly examined the impact of treatment approaches on health-related quality of life (HRQL) in people with dementia. This is of particular importance in therapies to address behavioural symptoms, where HRQL is often severely affected. MethodsAnalysis within the WHELD cluster randomised factorial study in 16 UK care homes examining the impact of person-centred care in combination with antipsychotic review, social interaction and exercise interventions. This study analysed impact on HRQL through the DEMQOL-Proxy. ResultsData on HRQL were available for 187 participants. People receiving antipsychotic review showed a significant worsening in two DEMQOL-Proxy domains (negative emotion: p=0.02; appearance: p=0.04). A best-case scenario analysis showed significant worsening for total DEMQOL-Proxy score. Social interaction intervention resulted in a significant benefit to HRQL (p=0.04). There was no deterioration in HRQL in groups receiving both antipsychotic review and social interaction (p=0.62). ConclusionsThis demonstrates an important detrimental impact of discontinuation of antipsychotics in dementia on HRQL, highlighting the need for careful review of best practice guidelines regarding antipsychotic use and emphasising the importance of providing evidence-based non-pharmacological interventions in conjunction with antipsychotic review. Copyright (c) 2016 John Wiley & Sons, Ltd.
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