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A systematic review of specialist inpatient dementia care services versus standard inpatient dementia care in acute hospitals

BACKGROUND: Specialist inpatient dementia units (SIDU) have been developed to address adverse outcomes often experienced by people living with dementia admitted to acute hospitals. However, the evidence base of their effectiveness remains limited. AIM: To review the current literature to establish t...

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Autores principales: McCausland, B. M. S., Patel, H. P., Amin, J., Baldwin, D. S., Loughran, K., Osman-Hicks, V. C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6491402/
https://www.ncbi.nlm.nih.gov/pubmed/30259497
http://dx.doi.org/10.1007/s40520-018-1021-y
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author McCausland, B. M. S.
Patel, H. P.
Amin, J.
Baldwin, D. S.
Loughran, K.
Osman-Hicks, V. C.
author_facet McCausland, B. M. S.
Patel, H. P.
Amin, J.
Baldwin, D. S.
Loughran, K.
Osman-Hicks, V. C.
author_sort McCausland, B. M. S.
collection PubMed
description BACKGROUND: Specialist inpatient dementia units (SIDU) have been developed to address adverse outcomes often experienced by people living with dementia admitted to acute hospitals. However, the evidence base of their effectiveness remains limited. AIM: To review the current literature to establish the comparative effectiveness of acute hospital SIDU vs. standard ward care (SWC). METHODS: We did an online search of 12 biomedical databases from inception to 31st October 2017. Studies of inpatients with any form of dementia in acute hospitals, published in English language peer-reviewed journals, using experimental, observational or qualitative study designs, comparing SIDU with SWC and which measured any qualitative or quantitative outcome of the patient or carer experience were included in the search criteria. We used a standardised data extraction and appraisal form. RESULTS: Three of 46 full-text studies evaluated were suitable for analysis. Due to study heterogeneity, pooled odds ratios were only possible for mortality [OR 1.06 (CI 1.0–1.4)]. Otherwise, a narrative synthesis was performed. Although quantitative measures of length of stay, mortality and behavioural and psychiatric symptoms of dementia are not significantly lower, SIDU are associated with greater patient and carer satisfaction, reduced readmission rates, more accurate and comprehensive assessment processes, documentation of resuscitation decisions, and increased rates of discharge to the patient’s own home. CONCLUSIONS: Although SIDU may be associated with improved care outcomes, the current evidence of their effectiveness is markedly limited. Further research and service evaluation of SIDU as a method for providing high-quality dementia care in acute NHS Trusts is needed. PROSPERO: CRD42017078364.
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spelling pubmed-64914022019-05-17 A systematic review of specialist inpatient dementia care services versus standard inpatient dementia care in acute hospitals McCausland, B. M. S. Patel, H. P. Amin, J. Baldwin, D. S. Loughran, K. Osman-Hicks, V. C. Aging Clin Exp Res Review BACKGROUND: Specialist inpatient dementia units (SIDU) have been developed to address adverse outcomes often experienced by people living with dementia admitted to acute hospitals. However, the evidence base of their effectiveness remains limited. AIM: To review the current literature to establish the comparative effectiveness of acute hospital SIDU vs. standard ward care (SWC). METHODS: We did an online search of 12 biomedical databases from inception to 31st October 2017. Studies of inpatients with any form of dementia in acute hospitals, published in English language peer-reviewed journals, using experimental, observational or qualitative study designs, comparing SIDU with SWC and which measured any qualitative or quantitative outcome of the patient or carer experience were included in the search criteria. We used a standardised data extraction and appraisal form. RESULTS: Three of 46 full-text studies evaluated were suitable for analysis. Due to study heterogeneity, pooled odds ratios were only possible for mortality [OR 1.06 (CI 1.0–1.4)]. Otherwise, a narrative synthesis was performed. Although quantitative measures of length of stay, mortality and behavioural and psychiatric symptoms of dementia are not significantly lower, SIDU are associated with greater patient and carer satisfaction, reduced readmission rates, more accurate and comprehensive assessment processes, documentation of resuscitation decisions, and increased rates of discharge to the patient’s own home. CONCLUSIONS: Although SIDU may be associated with improved care outcomes, the current evidence of their effectiveness is markedly limited. Further research and service evaluation of SIDU as a method for providing high-quality dementia care in acute NHS Trusts is needed. PROSPERO: CRD42017078364. Springer International Publishing 2018-09-26 2019 /pmc/articles/PMC6491402/ /pubmed/30259497 http://dx.doi.org/10.1007/s40520-018-1021-y Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Review
McCausland, B. M. S.
Patel, H. P.
Amin, J.
Baldwin, D. S.
Loughran, K.
Osman-Hicks, V. C.
A systematic review of specialist inpatient dementia care services versus standard inpatient dementia care in acute hospitals
title A systematic review of specialist inpatient dementia care services versus standard inpatient dementia care in acute hospitals
title_full A systematic review of specialist inpatient dementia care services versus standard inpatient dementia care in acute hospitals
title_fullStr A systematic review of specialist inpatient dementia care services versus standard inpatient dementia care in acute hospitals
title_full_unstemmed A systematic review of specialist inpatient dementia care services versus standard inpatient dementia care in acute hospitals
title_short A systematic review of specialist inpatient dementia care services versus standard inpatient dementia care in acute hospitals
title_sort systematic review of specialist inpatient dementia care services versus standard inpatient dementia care in acute hospitals
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6491402/
https://www.ncbi.nlm.nih.gov/pubmed/30259497
http://dx.doi.org/10.1007/s40520-018-1021-y
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