Developing a complex intervention targeting antipsychotic prescribing to nursing home residents with dementia.
Authors
Walsh, Kieran
Byrne, Stephen
McSharry, Jenny
Browne, John
Irving, Kate
Hurley, Eimir
Rochford-Brennan, Helen
Geoghegan, Carmel
Presseau, Justin
Timmons, Suzanne
Affiliation
Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, T12XH60, Ireland. 2Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, T12YN60, Ireland. 3School of Public Health, University College Cork, Cork, T12K8AF, Ireland. 4Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Galway, H91TK33, Ireland. 5School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland. 6Centre for Health Policy and Management, Trinity College Dublin, Dublin, Ireland. 7Expert by Experience, N/A, N/A, Ireland. 8Irish Dementia Working Group, The Alzheimer Society of Ireland, Dublin, Ireland. 9Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, K1H 8L6, Canada. 10School of Epidemiology and Public Health, University of Ottawa, Ottawa, K1G 5Z3, Canada.Issue Date
19/02/2021Keywords
GUIDEDIntervention development
MRC framework
ANTIPSYCHOTICS
Behaviour change
complex interventions
dementia
Nursing homes
Patient and public involvement
Local subject classification
Access Awards 2021 SubmissionCommunity and Social Care
Metadata
Show full item recordPublisher
PMCJournal
HRB open researchDOI
10.12688/hrbopenres.13228.1PubMed ID
34136749Abstract
Background: Antipsychotics are commonly prescribed to people living with dementia in nursing home settings, despite strong guideline recommendations against their use except in limited circumstances. We aimed to transparently describe the development process for a complex intervention targeting appropriate requesting and prescribing of antipsychotics to nursing home residents with dementia in Ireland, by nurses and general practitioners (GPs) respectively. Methods: We report the development process for the 'Rationalising Antipsychotic Prescribing in Dementia' (RAPID) complex intervention, in accordance with the 'Guidance for reporting intervention development studies in health research' (GUIDED) checklist. The UK Medical Research Council framework for developing and evaluating complex interventions guided our overall approach, incorporating evidence and theory into the intervention development process. To unpack the intervention development process in greater detail, we followed the Behaviour Change Wheel approach. Guided by our stakeholders, we conducted three sequential studies (systematic review and qualitative evidence synthesis, primary qualitative study and expert consensus study), to inform the intervention development. Results: The RAPID complex intervention was developed in collaboration with a broad range of stakeholders, including people living with dementia and family carers, between 2015 and 2017. The finalised RAPID complex intervention was comprised of the following three components; 1) Education and training sessions with nursing home staff; 2) Academic detailing with GPs; 3) Introduction of an assessment tool to the nursing home. Conclusions: This paper describes the steps used by the researchers to develop a complex intervention targeting antipsychotic prescribing to nursing home residents with dementia in Ireland, according to the GUIDED checklist. We found that the GUIDED checklist provided a useful way of reporting all elements in a cohesive manner and complemented the other tools and frameworks used. Transparency in the intervention development processes can help in the translation of evidence into practice.Item Type
ArticleLanguage
enEISSN
2515-4826ae974a485f413a2113503eed53cd6c53
10.12688/hrbopenres.13228.1
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