scholarly journals Clinical outcomes of staff training in positive behaviour support to reduce challenging behaviour in adults with intellectual disability: cluster randomised controlled trial

2018 ◽  
Vol 212 (3) ◽  
pp. 161-168 ◽  
Author(s):  
Angela Hassiotis ◽  
Michaela Poppe ◽  
Andre Strydom ◽  
Victoria Vickerstaff ◽  
Ian S. Hall ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Randomised Controlled Trial ◽  
Staff Training ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Challenging Behaviour ◽  
Treatment As Usual ◽  
Cluster Randomised ◽  
Positive Behaviour Support ◽  
Randomised Controlled

BackgroundStaff training in positive behaviour support (PBS) is a widespread treatment approach for challenging behaviour in adults with intellectual disability.AimsTo evaluate whether such training is clinically effective in reducing challenging behaviour during routine care (trial registration: NCT01680276).MethodWe carried out a multicentre, cluster randomised controlled trial involving 23 community intellectual disability services in England, randomly allocated to manual-assisted staff training in PBS (n = 11) or treatment as usual (TAU, n = 12). Data were collected from 246 adult participants.ResultsNo treatment effects were found for the primary outcome (challenging behaviour over 12 months, adjusted mean difference = −2.14, 95% CI: −8.79, 4.51) or secondary outcomes.ConclusionsStaff training in PBS, as applied in this study, did not reduce challenging behaviour. Further research should tackle implementation issues and endeavour to identify other interventions that can reduce challenging behaviour.Declaration of interestNone.

scholarly journals Staff training in positive behaviour support for behaviour that challenges in people with intellectual disability: cost-utility analysis of a cluster randomised controlled trial

BJPsych Open ◽  
2020 ◽  
Vol 6 (2) ◽  
Author(s):  
Rachael Maree Hunter ◽  
Victoria Vickerstaff ◽  
Michaela Poppe ◽  
Andre Strydom ◽  
Michael King ◽  
...  
Keyword(s):  
Staff Training ◽  
Controlled Trial ◽  
Cost Effective ◽  
Cluster Randomised Controlled Trial ◽  
Cost Utility ◽  
Utility Analysis ◽  
Cluster Randomised ◽  
Positive Behaviour Support ◽  
Randomised Controlled ◽  
The Cost

Background Behaviour that challenges in people with intellectual disability is associated with higher healthcare, social care and societal costs. Although behavioural therapies are widely used, there is limited evidence regarding the cost and quality-adjusted life-years (QALYs). Aims We aimed to assess the incremental cost per QALY gained of therapist training in positive behaviour support (PBS) and treatment as usual (TAU) compared with TAU using data from a cluster randomised controlled trial (Clinical Trials.gov registration: NCT01680276). Method We conducted a cost-utility analysis (cost per QALY gained) of 23 teams randomised to PBS or TAU, with a total of 246 participants followed up over 36 months. The primary analysis was from a healthcare cost perspective with a secondary analysis from a societal cost perspective. Results Over 36 months the intervention resulted in an additional 0.175 QALYs (discounted and adjusted 95% CI −0.068 to 0.418). The total cost of training in and delivery of PBS is £1598 per participant plus an additional cost of healthcare of £399 (discounted and adjusted 95% CI −603 to 1724). From a healthcare cost perspective there is an 85% probability that the intervention is cost-effective compared with TAU at a £30 000 willingness to pay for a QALY threshold. Conclusions There was a high probability that training in PBS is cost-effective as the cost of training and delivery of PBS is balanced out by modest improvements in quality of life. However, staff training in PBS is not supported given we found no evidence for clinical effectiveness.

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