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Table 7 Description of included primary studies for the comparison activity program versus usual care

From: Effect of interventions to reduce potentially inappropriate use of drugs in nursing homes: a systematic review of randomised controlled trials

Study

Participants

Interventions

Comparison

Outcomes

Rovner

1996 [25]

42 residents in the intervention group and 39 residents in the control group in a 250 beds nursing home in USA.

Mean age: 82 years.

Aimed at reducing behaviour disorders in residents with dementia. Program with three components:

- Daily 5 hours activity program with music, exercise, crafts, relaxation, reminiscences, word games and food preparation

- Guidelines for psychotropic drug management. Psychotropic drugs were considered as potentially inappropriate and the aim was to reduce their use. Prescribing were turned over to the psychiatrist.

- Weekly 1 hour educational meetings between the study psychiatrist and activities staff that focused on patients' predisposing features to behavioural disorders. Each patient's behavioral, funtional and medical status were discussed.

Extent of implementation: Thirty-eight of 42 (92.8%) intervention patients attended the activity program daily. Three patients and one patient's family refused participation. On average, intervention patients spent 17.0 (5.9) hours per week in the activity program. Activity levels for controls were observed four times during the 6 month period (months 2, 3, 5, 6) and revealed that an average of 23.4% (5.1) participated in nursing home provided activities. At 6 months, intervention patients were more than 10 times more likely to participate in activities than were controls (OR = 13.71; 95% CI [4.50, 41.73]; P <.001).

Usual care, i.e. each resident had about 3 to 6 activity hours each week: discussion group, arts and crafts, special programs with outside entertainers and bedside sensory stimulation. The physician could make contact with the psychiatrist if needed. Usual care was modified by the intervention: when intervention residents participated in acitivites elsewhere, the nurse to resident ratio increased in the nursing unit.

Number of residents using antipsychotics, number of drugs, use of physical restraint.