scholarly journals Efficacy of Atypical Antipsychotics to Treat Behavioral and Psychological Symptoms of Dementia in Nursing Home Residents: A Systematic Review of the Evidence from Randomized Controlled Trials

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Huai Yong Cheng
Keyword(s):  
Systematic Review ◽  
Nursing Home ◽  
Randomized Controlled Trials ◽  
Atypical Antipsychotics ◽  
Psychological Symptoms ◽  
Nursing Home Residents ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Behavioral And Psychological Symptoms

Prevention of Healthcare-Associated Pneumonia with Oral Care in Individuals Without Mechanical Ventilation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2015 ◽  
Vol 36 (8) ◽  
pp. 899-906 ◽  
Author(s):  
Asako Kaneoka ◽  
Jessica M. Pisegna ◽  
Keri V. Miloro ◽  
Mel Lo ◽  
Hiroki Saito ◽  
...  
Keyword(s):  
Nursing Home ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Oral Care ◽  
Nursing Home Residents ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Preventive Effect ◽  
Randomized Controlled ◽  
Healthcare Associated

OBJECTIVEEvidence is lacking on the preventive effect of oral care on healthcare-associated pneumonia in hospitalized patients and nursing home residents who are not mechanically ventilated. The primary aim of this review was to assess the effectiveness of oral care on the incidence of pneumonia in nonventilated patients.METHODSWe searched 8 databases (MEDLINE, Embase, CENTRAL, CINAHL, Web of Science, LILACS, ICHUSHI, and CiNii), in addition to trial registries and a manual search. Eligible studies were published and unpublished randomized controlled trials examining the effect of any method of oral care on reported incidence of pneumonia and/or fatal pneumonia. Relative risks (RR) and 95% confidence intervals were calculated. Risk of bias was assessed for eligible studies.RESULTSWe identified 5 studies consisting of 1,009 subjects that met the inclusion criteria. Of these, 2 trials assessed the effect of chlorhexidine in hospitalized patients; 3 studies examined mechanical oral cleaning in nursing home residents. A meta-analysis could only be done on 4 trials; this analysis showed a significant risk reduction in pneumonia through oral care interventions (RRfixed, 0.61; 95% CI, 0.40–0.91; P=.02). The effects of mechanical oral care alone were significant when pooled across studies. (RRfixed, 0.61; 95% CI, 0.40–0.92; P=.02). Risk reduction for fatal pneumonia from mechanical oral cleaning was also significant (RRfixed, 0.41; 95% CI, 0.23–0.71; P=.002). Most studies had a high risk of bias.CONCLUSIONSThis analysis suggests a preventive effect of oral care on pneumonia in nonventilated individuals. This effect, however, should be interpreted with caution due to risk of bias in the included trials.Infect Control Hosp Epidemiol 2015;36(8): 899–906

scholarly journals Treatment effects of Ginkgo biloba extract EGb 761® on the spectrum of behavioral and psychological symptoms of dementia: meta-analysis of randomized controlled trials

2017 ◽  
Vol 30 (3) ◽  
pp. 285-293 ◽  
Author(s):  
Egemen Savaskan ◽  
Heiko Mueller ◽  
Robert Hoerr ◽  
Armin von Gunten ◽  
Serge Gauthier
Keyword(s):  
Randomized Controlled Trials ◽  
Ginkgo Biloba ◽  
Fixed Effects ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Caregiver Distress ◽  
Egb 761 ◽  
Randomized Controlled ◽  
Behavioral And Psychological Symptoms

ABSTRACTBackground:In randomized controlled trials, Ginkgo biloba extract EGb 761® has been found to be effective in the treatment of behavioral and psychological symptoms of dementia (BPSD).Methods:To assess the effects of EGb 761® on specific BPSD, we analyzed data from all randomized, placebo-controlled, at least 20-week, trials of EGb 761® enrolling patients with dementia (probable Alzheimer's disease (AD), probable vascular dementia or probable AD with cerebrovascular disease) who had clinically significant BPSD (Neuropsychiatric Inventory (NPI) total score at least 6). Data were pooled and joint analyses of NPI single item composite and caregiver distress scores were performed by meta-analysis with a fixed effects model.Results:Four trials involving 1628 patients (EGb 761®, 814; placebo, 814) were identified; treatment duration was 22 or 24 weeks; the daily dose of EGb 761® was 240 mg in all trials. Pooled analyses including data from the full analysis sets of all trials (EGb 761®, 796 patients; placebo, 802 patients) revealed significant superiority of EGb 761® over placebo in total scores and 10 single symptom scores. Regarding caregiver distress scores, EGb 761®-treated patients improved significantly more than those receiving placebo in all symptoms except delusions, hallucinations, and elation/euphoria. The benefit of EGb 761® mainly consists of improvement in symptoms present at baseline, but the incidence of some symptoms was also decreased.Conclusions:Twenty two- to twenty four-week treatment with Ginkgo biloba extract EGb 761® improved BPSD (except psychotic-like features) and caregiver distress caused by such symptoms.

scholarly journals A systematic review of non-pharmacological interventions for BPSD in nursing home residents with dementia: from a perspective of ergonomics

2018 ◽  
Vol 31 (08) ◽  
pp. 1137-1149 ◽  
Author(s):  
Gubing Wang ◽  
Armagan Albayrak ◽  
Tischa J. M. van der Cammen
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Nursing Home ◽  
Psychological Symptoms ◽  
Nursing Home Residents ◽  
Inclusion Criteria ◽  
Pharmacological Interventions ◽  
Quality Of Evidence ◽  
Behavioral And Psychological Symptoms

ABSTRACTBackground:Non-pharmacological interventions for Behavioral and Psychological Symptoms of Dementia (BPSD) have been developed; however, a systematic review on the effectiveness of this type of intervention from a perspective of ergonomics is lacking. According to ergonomics, the capabilities of Persons with Dementia (PwD) should be considered in the interventions for the outcomes to be reliable. We aimed to systematically review the non-pharmacological interventions for BPSD in nursing home residents with an additional assessment criterion based on ergonomics, specifically, capability consideration.Methods:The electronic databases MEDLINE, EMBASE, and PsycINFO were searched for non-pharmacological interventions treating BPSD in nursing homes. The interventions were categorized according to the capabilities of PwD required to participate. Study quality was assessed by National Health and Medical Research Council (NHMRC) evidence hierarchy and the capability consideration.Results:Sixty-four clinical trials met the inclusion criteria; 41 trials reported a significant reduction in at least one BPSD symptom; 20 trials reported no significant reduction in BPSD symptoms; three trials reported adverse effects after the intervention. Interventions were categorized into sensory-, cognition-, and movement-oriented. Capabilities of PwD were not considered in 28 trials, especially for sensory capabilities.Conclusions:The majority of the clinical trials reported a significant reduction in BPSD. The quality of evidence for nonpharmacological interventions in these trials is low due to the lack of capability consideration, data inhomogeneity, and inadequate study design and reporting. Future studies should focus on improving the quality of evidence by including capability consideration and examining if a relationship between capability consideration and effectiveness of non-pharmacological interventions exists.

Sign in / Sign up

Export Citation Format

Share Document