Abstract
BackgroundSpecialist community teams often support people with dementia who experience crisis. These teams may vary in composition and models of practice, which presents challenges when evaluating their effectiveness. A best practice model for dementia crisis services could be used by teams to improve the quality and effectiveness of the care they deliver.ObjectiveThe aim of this study is to examine the feasibility of conducting a large-scale randomized controlled trial comparing the AQUEDUCT (Achieving Quality and Effectiveness in Dementia Using Crisis Teams) Resource Kit intervention to treatment as usual.MethodsThis is a multisite feasibility study in preparation for a future randomized controlled trial. Up to 54 people with dementia (and their carers) and 40 practitioners will be recruited from 4 geographically widespread teams managing crisis in dementia. Quantitative outcomes will be recorded at baseline and at discharge. This study will also involve a nested health economic substudy and qualitative research to examine participant experiences of the intervention and acceptability of research procedures.ResultsEthical approval for this study was granted in July 2019. Participant recruitment began in September 2019, and as of September 2020, all data collection has been completed. Results of this study will establish the acceptability of the intervention, recruitment rates, and will assess the feasibility and appropriateness of the outcome measures in preparation for a large-scale randomized controlled trial.ConclusionsThere is a need to evaluate the effectiveness of crisis intervention teams for older people with dementia. This is the first study to test the feasibility of an evidence-based best practice model for teams managing crisis in dementia. The results of this study will assist in the planning and delivery of a large-scale randomized controlled trial.International Registered Report Identifier (IRRID)DERR1-10.2196/18971
Highlights
BackgroundDementia is a progressive condition that affects over 850,000 people in the United Kingdom [1]
With the aim of reducing hospital admissions, is one way to respond to this policy initiative; fluctuations in the health and social circumstances of the person with dementia may cause a breakdown in care which could lead to crisis
A recent scoping survey [6] highlighted the disparity in services across England; teams managing crisis in dementia vary in terms of name, set-up, delivery, policy, and procedures
Summary
Dementia is a progressive condition that affects over 850,000 people in the United Kingdom [1]. Support for people with dementia and their carers at a time of crisis is often managed through secondary mental health services These services involve teams that vary in name and composition and may include crisis resolution and home treatment teams and dementia rapid response teams, though in some instances, there are no suitable services. The first work package (WP1) consisted of 2 strands: a systematic literature review to examine the effectiveness of crisis interventions for older people and a scoping review to map and understand operational procedures in current services [6], and subsequently, qualitative work (including interviews; focus groups; consultations; and a consensus conference involving people with dementia, carers, practitioners, and stakeholders) was used to identify and establish agreement about key elements of best practice in teams managing crisis in dementia.
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