School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.
Department of Rehabilitation Aged and Extended Care, Flinders University, Adelaide, South Australia.
Int Psychogeriatr. 2021 Sep;33(9):947-975. doi: 10.1017/S1041610220001702. Epub 2020 Nov 16.
This study aimed to identify the nature and effects of implementation strategies to increase the use of evidence-based, non-pharmacological interventions designed to reduce the frequency and/or severity of behavioral and psychological symptoms associated with dementia, for people living in the community.
This was a systematic review of implementation studies. We searched six databases (in January 2019) and hand-searched reference lists of reports. Studies were included if they used quantitative methods evaluating the use of implementation strategies to increase the use of non-pharmacological interventions. These interventions had to have been tested in a randomized controlled trial (RCT) and found to reduce behavioral and psychological symptoms of dementia, for those living in the community. Studies needed to report the effect of the implementation on clinical practice, for example, a change in practice or the adoption of the intervention in community settings.
Twelve studies were included: 11 one-group pre-post design studies and 1 cluster RCT. All studies reported practice change - the majority implementing a new intervention, with six different types of interventions implemented. All studies reported including using partnerships, new funding, educational strategies, and ongoing support and consultation. Seven implementation studies reported positive outcomes for clients on some aspect of behavior or depression for the person with dementia.
Implementation studies using multiple implementation strategies to increase the use of non-pharmacological interventions have demonstrated improvements in behavioral and psychological symptoms common in people with dementia, when provided by clinicians as part of their everyday work routines.
本研究旨在确定旨在增加使用基于证据的非药物干预措施的实施策略的性质和效果，这些干预措施旨在减少与痴呆相关的行为和心理症状的频率和/或严重程度，适用于社区中生活的人群。
这是一项实施研究的系统评价。我们搜索了六个数据库（2019 年 1 月）并手动搜索了报告的参考文献列表。如果使用定量方法评估实施策略的使用情况以增加非药物干预措施的使用，则纳入研究。这些干预措施必须在随机对照试验 (RCT) 中进行过测试，并且已被发现可以减轻社区中生活的人群的痴呆行为和心理症状。研究需要报告实施对临床实践的影响，例如，实践的改变或干预措施在社区环境中的采用。
共纳入 12 项研究：11 项单组前后设计研究和 1 项群组 RCT。所有研究均报告了实践上的改变——大多数实施了新的干预措施，共实施了六种不同类型的干预措施。所有研究都报告了包括利用合作伙伴关系、新资金、教育策略以及持续的支持和咨询。有 7 项实施研究报告了针对痴呆患者的某些行为或抑郁方面的客户有积极的结果。
使用多种实施策略来增加非药物干预措施的使用的实施研究表明，当临床医生将其作为日常工作常规的一部分提供时，可改善痴呆患者常见的行为和心理症状。
