Trivedi Daksha, Goodman Claire, Dickinson Angela, Gage Heather, McLaughlin Jennifer, Manthorpe Jill, Ashaye Kunle, Iliffe Steve
University of Hertfordshire, Hatfield, UK.
Syst Rev. 2013 Aug 28;2:70. doi: 10.1186/2046-4053-2-70.
Non-cognitive behavioural and psychological symptoms of dementia affect up to 90% of people with dementia during the disease course and result in distress, increased carer burden, high service utilization and unwanted moves to care homes. Research has focused on long-term settings and has not considered people with dementia living at home and at different stages of the disease trajectory. Our aim is to review systematically the evidence concerning non-pharmacological strategies to minimise behavioural and psychological symptoms in community-dwelling older people with dementia.
METHODS/DESIGN: Our approach is a two-stage co-design: a systematic mapping of the broad evidence around behavioural and psychological symptoms followed by an in-depth systematic review of studies of non-pharmacological interventions for behavioural and psychological symptoms from the perspective of their impact on community-dwelling older people with dementia and their carers. The review will include published literature involving a wide range of electronic databases using sensitive and comprehensive searches and lateral searching including checking citations.We will produce a descriptive map of the studies by design and by the focus of interventions and apply further inclusion criteria, developed in conjunction with lay experts, to select studies for an in-depth systematic review that will include independent quality assessment and detailed data extraction by two reviewers.The review process will be integrated with stakeholder meetings and a multidisciplinary expert advisory group to guide the review parameters and shape the research questions on the management of behavioural and psychological symptoms in people with dementia. Because studies are likely to be diverse in methodology and interventions, we will conduct a narrative synthesis of the in-depth systematic review. If appropriate, we will pool studies in a meta-analysis. We will explore review findings at both stages through focus groups and interviews with service providers, practitioners, people with dementia and carers.
This integrated review in collaboration with key stakeholders will synthesise research evidence to identify appropriate interventions for effective management of behavioural and psychological symptoms that supports people with dementia living at home and their carers, and which reflects their priorities. It will make recommendations for research and practice.
PROSPERO registration number: CRD42013004344.
痴呆症的非认知行为和心理症状在疾病过程中影响高达90%的痴呆症患者，会导致痛苦、护理负担加重、高服务利用率以及不必要地搬入养老院。研究主要集中在长期护理环境，未考虑居家且处于疾病轨迹不同阶段的痴呆症患者。我们的目的是系统回顾关于非药物策略以尽量减少社区居住的老年痴呆症患者行为和心理症状的证据。
方法/设计：我们的方法是两阶段协同设计：首先对围绕行为和心理症状的广泛证据进行系统映射，然后从对社区居住的老年痴呆症患者及其护理人员的影响角度，对行为和心理症状的非药物干预研究进行深入系统回顾。该回顾将包括通过敏感且全面的检索以及横向检索（包括检查参考文献）涉及广泛电子数据库的已发表文献。我们将按设计和干预重点制作研究描述图，并应用与非专业专家共同制定的进一步纳入标准，选择研究进行深入系统回顾，其中将包括两名评审员进行的独立质量评估和详细数据提取。回顾过程将与利益相关者会议和多学科专家咨询小组相结合，以指导回顾参数并确定关于痴呆症患者行为和心理症状管理的研究问题。由于研究在方法和干预方面可能多种多样，我们将对深入系统回顾进行叙述性综合。如果合适，我们将在荟萃分析中汇总研究。我们将通过焦点小组以及与服务提供者、从业者、痴呆症患者和护理人员的访谈，在两个阶段探索回顾结果。
与关键利益相关者合作进行的这项综合回顾将综合研究证据，以确定有效管理行为和心理症状的适当干预措施，这些措施支持居家的痴呆症患者及其护理人员，并反映他们的优先事项。它将为研究和实践提出建议。
PROSPERO注册号：CRD42013004344。
