నైరూప్య
Pilot study and key feasibility factors of a staff training intervention and reduction of antipsychotic prescription practice in Mexican urban care homes: study protocol.
Sara Torres-Castro, Mariana López-Ortega, Adrián MartÃnez-Ruiz, Luis Miguel Gutiérrez-Robledo, Azucena Guzmán
Background: In a context of rapid population ageing and increase in chronic illnesses including dementia in Mexico, there is a need to develop long-term care strategies in order to improve the quality of life, people affected by dementia and the people that care for them. In 2015, the prevalence of dementia in Mexico was 6.1% and it is estimated to reach to over 1.5 million by the year 2030, posing a great challenge to formal and informal caregivers. In 2014, Mexico developed a Dementia Strategy National Plan (Plan de Acción Alzheimer y otras demencias) and the objectives eight and nine of it aims to train the care work force on non-pharmacological and health professionals in care homes, and improve the appropriate antipsychotic prescription to treat challenging behavior respectively. Previous UK-based studies have been successful in training staff and health professionals by optimizing the prescription of antipsychotic medication and by implementing psychosocial interventions to treat behavioral and psychological symptoms associated to dementia. Objective: The aim of this study was to develop PROCUIDA-Demencia (in Spanish: Programa para el Cuidado Optimo en Demencia), a staff training package. Methods: A randomized controlled mixed methods feasibility study in eight care homes (N=500 beds approximately). The goal of the study is to investigate a set of interventions to promote psychosocial activities and review antipsychotic medication to treat Behavioral and Psychological Symptoms of dementia. This is a twelve weeks and follow up study that involves the development of the staff training package for Mexican care homes (PROCUIDA-Demencia) based on two arms: Staff Training with PROCUIDA-Demencia vs Treatment as Usual (TAU). Conclusions: If feasible, PROCUIDA-Demencia Staff Training Model could be developed in a larger an easy-to-use set of therapies that benefit cognition, behavior, mood and quality of life in individuals with Dementia, and to staff in care homes across Mexico. It is expected that the results will provide the base for establishing a larger randomised control trial.