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Record W4280540563 · doi:10.1017/s1041610222000321

Impact of standardizing care for agitation in dementia using an integrated care pathway on an inpatient geriatric psychiatry unit

2022· article· en· W4280540563 on OpenAlexafffund
Sanjeev Kumar, Amruta Shanbhag, Amer M. Burhan, Sarah Colman, Philip Gerretsen, Ariel Graff‐Guerrero, Donna Kim, Clement Ma, Benoit H. Mulsant, Bruce G. Pollock, Vincent L. Woo, Simon Davies, Tarek K. Rajji

Bibliographic record

VenueInternational Psychogeriatrics · 2022
Typearticle
Languageen
FieldPsychology
TopicHealthcare Decision-Making and Restraints
Canadian institutionsGlenrose Rehabilitation HospitalUniversity of AlbertaUniversity of TorontoToronto Dementia Research AllianceOntario Shores Centre for Mental Health SciencesPublic Health OntarioCentre for Addiction and Mental Health
FundersTemerty Faculty of Medicine, University of TorontoNational Institutes of HealthUniversity of TorontoNational Institute for Health and Care ResearchConsortium canadien en neurodégénérescence associée au vieillissementNorthern Ontario Academic Medicine AssociationCentre for Addiction and Mental HealthPhysicians' Services Incorporated FoundationAmerican Foundation for Suicide PreventionBrightFocus FoundationEli Lilly and CompanyPatient-Centered Outcomes Research InstituteCanadian Institutes of Health ResearchCentre for Addiction and Mental Health FoundationFondation Brain CanadaPfizer
KeywordsGeriatric psychiatryDementiaGeriatric careMedicinePsychiatryUnit (ring theory)Gerontological nursingPsychologyNursingDiseaseInternal medicine

Abstract

fetched live from OpenAlex

OBJECTIVES: This study examined the effectiveness of an integrated care pathway (ICP), including a medication algorithm, to treat agitation associated with dementia. DESIGN: Analyses of data (both prospective and retrospective) collected during routine clinical care. SETTING: Geriatric Psychiatry Inpatient Unit. PARTICIPANTS: Patients with agitation associated with dementia (n = 28) who were treated as part of the implementation of the ICP and those who received treatment-as-usual (TAU) (n = 28) on the same inpatient unit before the implementation of the ICP. Two control groups of patients without dementia treated on the same unit contemporaneously to the TAU (n = 17) and ICP groups (n = 36) were included to account for any secular trends. INTERVENTION: ICP. MEASUREMENTS: Cohen Mansfield Agitation Inventory (CMAI), Neuropsychiatric Inventory Questionnaire (NPIQ), and assessment of motor symptoms were completed during the ICP implementation. Chart review was used to obtain length of inpatient stay and rates of psychotropic polypharmacy. RESULTS: Patients in the ICP group experienced a reduction in their scores on the CMAI and NPIQ and no changes in motor symptoms. Compared to the TAU group, the ICP group had a higher chance of an earlier discharge from hospital, a lower rate of psychotropic polypharmacy, and a lower chance of having a fall during hospital stay. In contrast, these outcomes did not differ between the two control groups. CONCLUSIONS: These preliminary results suggest that an ICP can be used effectively to treat agitation associated with dementia in inpatients. A larger randomized study is needed to confirm these results.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.470
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0010.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0010.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.047
GPT teacher head0.428
Teacher spread0.380 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations9
Published2022
Admission routes2
Has abstractyes

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