Educating Nursing Home Staff in Dementia Sensitive Communication: Impact on Antipsychotic Medication Use.
Clarissa Shaw, Kristine N Williams, Yelena Perkhounkova
PMID 30471803WHAT IT FOUND
Compared with Kansas averages, the CHAT homes' antipsychotic reduction was not significant (p=.06).
Within those 10 homes, use fell from 20.71% to 15.83% (p=.03).
Key findings
01The 10 CHAT nursing homes decreased antipsychotic use among long-stay residents from 20.71% to 15.83%, an average decrease of 4.88 percentage points (p=.03).
02In the same quarters, Kansas nursing homes decreased antipsychotic use from 25.39% to 24.71%, an average decrease of 0.68 percentage points.
03The CHAT homes showed a 23.6% decrease compared with a 2.7% state decrease, but that difference did not reach significance (p=.06).
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This is a post hoc secondary analysis of facility-level public data, not a direct test of CHAT effects on individual residents. One of 11 nursing homes was excluded for missing pre-intervention antipsychotic data, leaving 10 homes. The analysis used facility-wide antipsychotic rates, which may include residents without dementia and staff who did not attend CHAT training. The degree to which staff implemented CHAT skills is unknown. CHAT effects on elderspeak decline over time, and five of the 10 homes showed an increase in antipsychotic use in the second quarter after CHAT. The small sample may have contributed to the lack of statistically significant findings. The CHAT homes were mostly non-profit and had slightly higher star ratings, but they also had more dignity citations, so they may not represent all nursing homes. The CHAT program did not focus on antipsychotic reduction, and nursing assistants were not the decision makers for antipsychotic administration.
Declared interests
All authors declare no conflicts of interest. The supplied metadata lists NIH extramural research support.
The easy way to misread this
Do not conclude that CHAT training caused lower antipsychotic use. This was a secondary analysis of facility-level public data, the CHAT program did not target antipsychotic reduction, staff implementation was unknown, other nursing home efforts may have contributed, and the comparison with state averages did not reach significance.