Abstract
BackgroundThe aim of this study is evaluating the (cost-) effectiveness of a multidisciplinary, evidence based care program to improve the management of depression in nursing home residents of somatic and dementia special care units. The care program is an evidence based standardization of the management of depression, including standardized use of measurement instruments and diagnostical methods, and protocolized psychosocial, psychological and pharmacological treatment.Methods/DesignIn a 19-month longitudinal controlled study using a stepped wedge design, 14 somatic and 14 dementia special care units will implement the care program. All residents who give informed consent on the participating units will be included. Primary outcomes are the frequency of depression on the units and quality of life of residents on the units. The effect of the care program will be estimated using multilevel regression analysis. Secondary outcomes include accuracy of depression-detection in usual care, prevalence of depression-diagnosis in the intervention group, and response to treatment of depressed residents. An economic evaluation from a health care perspective will also be carried out.DiscussionThe care program is expected to be effective in reducing the frequency of depression and in increasing the quality of life of residents. The study will further provide insight in the cost-effectiveness of the care program.Trial registrationNetherlands Trial Register (NTR): NTR1477
Highlights
The aim of this study is evaluating the effectiveness of a multidisciplinary, evidence based care program to improve the management of depression in nursing home residents of somatic and dementia special care units
The care program is expected to be effective in reducing the frequency of depression and in increasing the quality of life of residents
Economic evaluation This study investigates the efficiency of the care program Act In case of Depression (AID) compared to usual care as provided in nursing home (NH) units
Summary
The aim of this study is evaluating the (cost-) effectiveness of a multidisciplinary, evidence based care program to improve the management of depression in nursing home residents of somatic and dementia special care units. The care program is an evidence based standardization of the management of depression, including standardized use of measurement instruments and diagnostical methods, and protocolized psychosocial, psychological and pharmacological treatment. Depression is strongly related to quality of life of NH residents [4], it seriously impacts wellbeing and daily functioning, and increases use of health care services and even mortality [5,6,7]. Several studies have demonstrated effects of pharmacological and psychosocial interventions for depression in nursing homes [13,14]. There is evidence for the effectiveness of multifaceted interventions in residential care [16,17,18] and in nursing homes [19,20]
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