A systematic review of specialist inpatient dementia care services versus standard inpatient dementia care in acute hospitals
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 the comparative effectiveness of acute hospital SIDU versus standard ward care (SWC).
Methods: computerised searches 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.
595-610
McCausland, Beth
761ba09b-a55b-4752-9e0c-73a311ee26f6
Patel, Harnish
e1c0826f-d14e-49f3-8049-5b945d185523
Amin, Jay
692a8880-70ff-4b64-a7e9-7d0d53449a30
Baldwin, David
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Loughran, Kieran
4a59f882-3445-4141-a5c2-958c4b1c5a74
Osman-Hicks, Victoria
9df6f4a4-36ea-46a7-ba49-58ac022445ee
May 2019
McCausland, Beth
761ba09b-a55b-4752-9e0c-73a311ee26f6
Patel, Harnish
e1c0826f-d14e-49f3-8049-5b945d185523
Amin, Jay
692a8880-70ff-4b64-a7e9-7d0d53449a30
Baldwin, David
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Loughran, Kieran
4a59f882-3445-4141-a5c2-958c4b1c5a74
Osman-Hicks, Victoria
9df6f4a4-36ea-46a7-ba49-58ac022445ee
McCausland, Beth, Patel, Harnish, Amin, Jay, Baldwin, David, Loughran, Kieran and Osman-Hicks, Victoria
(2019)
A systematic review of specialist inpatient dementia care services versus standard inpatient dementia care in acute hospitals.
Aging Clinical and Experimental Research, 31 (5), , [ACER-D-18-00306].
(doi:10.1007/s40520-018-1021-y).
Abstract
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 versus standard ward care (SWC).
Methods: computerised searches 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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McCausland 2018 Article A Systematic Review
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Accepted/In Press date: 4 August 2018
e-pub ahead of print date: 26 September 2018
Published date: May 2019
Identifiers
Local EPrints ID: 424618
URI: http://eprints.soton.ac.uk/id/eprint/424618
ISSN: 1594-0667
PURE UUID: 3f9073da-6188-4eec-80ed-7166fd288ff2
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Date deposited: 05 Oct 2018 11:39
Last modified: 24 Apr 2024 04:04
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Author:
Beth McCausland
Author:
Harnish Patel
Author:
Kieran Loughran
Author:
Victoria Osman-Hicks
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