Table 2. Clinical Outcomes of Focused Psychotropic Medication Review.
| Source | Clinical Outcome | Measure | Result |
|---|---|---|---|
| Randomized Clinical Trials | |||
| Ballard et al,23 2016 | Neuropsychiatric symptoms | Neuropsychiatric Inventory | Difference between intervention and control groups favors control 7.37 (95% CI, 1.53-13.22; P = .02)a |
| Agitation | Cohen-Mansfield Agitation Inventory | Difference between intervention and control groups: 4.60 (95% CI, −1.43 to 10.63; P = .13) | |
| Depression | Cornell Scale for Depression in Dementia | Difference between intervention and control groups: −1.70 (95% CI, −4.29 to 0.90; P = .19) | |
| Mortality | Death | OR, 0.67 (95% CI, 0.39-1.14; P = .15) | |
| Ballard et al,24 2017 | Proxy health-related quality of life | DEMQOL: Dementia-Related Quality of Life measure | Difference between intervention and control groups: 4.54 (95% CI, −9.26 to 0.19; P = .06) |
| Moncrieff et al,25 2016 | Clinical symptoms of severe mental illness | Brief Positive and Negative Syndrome Scale | Difference between intervention and control groups: 0.13 (95% CI, −2.20 to 2.48) |
| Antipsychotic drug adverse effects | Liverpool University Neuroleptic Side-Effect Rating Scale | Difference between intervention and control groups: −0.42 (95% CI, −8.12 to 7.29) | |
| Medication adherence | Medication Adherence Questionnaire | Difference between intervention and control groups favors intervention: −0.44 (95% CI, −0.76 to −0.11)a | |
| Confidence in participating in clinical discussions and decisions | Decision Self-Efficacy Scale | Mean difference between intervention and control group: −4.16 (95% CI, −9.81 to 1.49) | |
| Patient satisfaction | Client Satisfaction Questionnaire | Difference between intervention and control groups: −0.29 (95% CI, −3.04 to 2.45) | |
| Attitude toward medication | Drug Attitude Inventory | Difference between intervention and control groups: 1.65 (95% CI, −0.09 to 3.40) | |
| Jordan et al,26 2015 | Drug-related problems addressed (adverse effects) | Counts | Difference between intervention and control groups favors intervention: 3.34 (95% CI, 2.57-4.11; P < .001)a |
| Functional ability | Bristol Activities of Daily Living Scale | Mean difference between intervention and control group: 0.45 (95% CI, −0.47 to 0.93; P = .52) | |
| Dementia psychopathology | Manchester and Oxford Universities Scale for the Psychopathological Assessment of Dementia | Difference between intervention and control groups: 4.67 (95% CI, −0.04 to 2.78; P = .06) | |
| Patterson et al,27 2010 | Falls | Rate | 16.3 falls/100 person-mo in intervention group vs 11.4 falls/100 person-months in control group (P = .09) |
| Before-After Study Designs | |||
| Gallimore et al,42 2016 | Up-to-date laboratory monitoring | Proportion of participants | 54.1% (before); 72.1% (after) (P < .001)a |
| At risk of drug-drug interaction | Proportion of participants | 43.8% (before); 24.3% (after) (P < .001)a | |
| Movement adverse effect monitoring | Proportion of participants | 75.0% (before); 63.5% (after) (P = .21) | |
| Branford,29 1996 | Clinical presentation | Subjective assessment | 25% undergoing medication change had “good” outcome, 43% “poor” outcome, 32% “unclear” outcome |
| Jauernig et al,34 1995 | Challenging behavior | Frequency counts | Mean daily frequency of challenging behavior lower after the intervention than at baseline in 80% |
| Bisconer et al,28 1995 | Challenging behavior | Frequency counts | Mean decrease in challenging behavior after intervention |
| Reported medication adverse effects | Proportion of participants | (n = 11 [14%]) before intervention, (n = 8 [10%]) after intervention | |
| Glaser et al,32 1986 | Aggressive challenging behavior | Frequency counts | No significant difference between intervention and control groupsb |
| Inoue,33 1982 | Clinical presentation | Subjective assessment | “Positive change” in 96.5% receiving intervention, “negative” change in 3.5% |
| Ellenor et al,30 1977 | Challenging behavior | Aberrant Behavior Checklist | “Slight increase” in challenging behavior but no significant difference between intervention and control groupb |
Abbreviation: OR, odds ratio.
a
Results statistically significant at P < .05.
b
These studies had control groups only for the secondary outcome of change in challenging behavior.