Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway; Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway; Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Sem, Norway.
Am J Geriatr Psychiatry. 2018 Jan;26(1):25-38. doi: 10.1016/j.jagp.2017.05.015. Epub 2017 Jun 1.
To determine the effectiveness of the Targeted Interdisciplinary Model for Evaluation and Treatment of Neuropsychiatric Symptoms (TIME) for treatment of moderate to severe agitation in people with dementia.
In a single-blinded, cluster randomized controlled trial in 33 nursing homes (clusters) from 20 municipalities in Norway, 229 patients (104 patients in 17 nursing homes and 125 patients in 16 nursing homes) were randomized to an intervention or control group, respectively. The intervention group received TIME, and the control group received a brief education-only intervention. TIME is an interdisciplinary multicomponent intervention and consists of a comprehensive assessment of the patient with the goal to create and put into action a tailored treatment plan. The primary outcome was the between-group difference in change at the agitation/aggression item of the Neuropsychiatric Inventory Nursing Home version between baseline and 8 weeks. Secondary outcomes were the between-group difference in change at the agitation/aggression between baseline and 12 weeks in other neuropsychiatric symptoms, quality of life, and use of psychotropic and analgesic medications between baseline and 8 and 12 weeks.
A significant between-group difference in reduction of agitation at both 8 weeks (1.1; 95% confidence interval: 0.1-2.1; p = 0.03) and 12 weeks (1.6; 95% confidence interval: 0.6-2.7; p = 0.002) in favor of the TIME intervention was found.
The implementation of TIME resulted in a significant reduction of agitation among nursing homes patients with dementia. These results should inform training programs for care staff in Norway and internationally.
评估并治疗神经精神症状的靶向跨学科模型（TIME）对中重度痴呆患者激越症状的治疗效果。
在挪威 20 个市的 33 家养老院进行的单盲、集群随机对照试验中，将 229 名患者（17 家养老院的 104 名患者和 16 家养老院的 125 名患者）随机分为干预组和对照组。干预组接受 TIME 治疗，对照组仅接受简短的教育干预。TIME 是一种跨学科的多组分干预措施，包括对患者进行全面评估，以制定并实施个性化治疗计划。主要结局是在基线和 8 周时，神经精神疾病入院护理版（Neuropsychiatric Inventory Nursing Home version）激越/攻击项的组间变化差异。次要结局是在基线和 12 周时，其他神经精神症状、生活质量以及在基线和 8 周和 12 周时精神药物和止痛药物的使用方面的组间变化差异。
在 8 周（1.1；95%置信区间：0.1-2.1；p=0.03）和 12 周（1.6；95%置信区间：0.6-2.7；p=0.002）时，干预组的激越症状均显著减少，两组间存在显著差异。
TIME 的实施使痴呆养老院患者的激越症状显著减少。这些结果应该为挪威和国际上的护理人员培训计划提供信息。
