Academic Journal
The trial to reduce antimicrobial use in nursing home residents with Alzheimer’s disease and other dementias: study protocol for a cluster randomized controlled trial
| العنوان: | The trial to reduce antimicrobial use in nursing home residents with Alzheimer’s disease and other dementias: study protocol for a cluster randomized controlled trial |
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| المؤلفون: | Loizeau, Andrea J., D’Agata, Erika M. C., Shaffer, Michele L., Hanson, Laura C., Anderson, Ruth A., Tsai, Timothy, Habtemariam, Daniel A., Bergman, Elaine H., Carroll, Ruth P., Cohen, Simon M., Scott, Erin M. E., Stevens, Erin, Whyman, Jeremy D., Bennert, Elizabeth H., Mitchell, Susan L. |
| المساهمون: | National Institute on Aging, Schweizerische Akademie der Medizinischen Wissenschaften |
| المصدر: | Trials ; volume 20, issue 1 ; ISSN 1745-6215 |
| بيانات النشر: | Springer Science and Business Media LLC |
| سنة النشر: | 2019 |
| الوصف: | Background Infections are common in nursing home (NH) residents with advanced dementia but are often managed inappropriately. Antimicrobials are extensively prescribed, but frequently with insufficient evidence to support a bacterial infection, promoting the emergence of multidrug-resistant organisms. Moreover, the benefits of antimicrobials remain unclear in these seriously ill residents for whom comfort is often the goal of care. Prior NH infection management interventions evaluated in randomized clinical trials (RCTs) did not consider patient preferences and lack evidence to support their effectiveness in ‘real-world’ practice. Methods This report presents the rationale and methodology of TRAIN-AD (Trial to reduce antimicrobial use in nursing home residents with Alzheimer’s disease and other dementias), a parallel group, cluster RCT evaluating a multicomponent intervention to improve infection management for suspected urinary tract infections (UTIs) and lower respiratory tract infections (LRIs) among NH residents with advanced dementia. TRAIN-AD is being conducted in 28 facilities in the Boston, USA, area randomized in waves using minimization to achieve a balance on key characteristics ( N = 14 facilities/arm). The involvement of the facilities includes a 3-month start-up period and a 24-month implementation/data collection phase. Residents are enrolled during the first 12 months of the 24-month implementation period and followed for up to 12 months. Individual consent is waived, thus almost all eligible residents are enrolled (target sample size, N = 410). The intervention integrates infectious disease and palliative care principles and includes provider training delivered through multiple modalities (in-person seminar, online course, management algorithms, and prescribing feedback) and an information booklet for families. Control facilities employ usual care. The primary outcome, abstracted from the residents’ charts, is the number of antimicrobial courses prescribed for UTIs and LRIs per ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1186/s13063-019-3675-y |
| DOI: | 10.1186/s13063-019-3675-y.pdf |
| DOI: | 10.1186/s13063-019-3675-y/fulltext.html |
| الاتاحة: | http://dx.doi.org/10.1186/s13063-019-3675-y http://link.springer.com/content/pdf/10.1186/s13063-019-3675-y.pdf http://link.springer.com/article/10.1186/s13063-019-3675-y/fulltext.html |
| Rights: | http://creativecommons.org/licenses/by/4.0/ ; http://creativecommons.org/licenses/by/4.0/ |
| رقم الانضمام: | edsbas.65A82AB8 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1186/s13063-019-3675-y |
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