Comparative efficacy of non-pharmacological interventions on agitation in people with dementia: A systematic review and Bayesian network meta-analysis

Agitation in people with dementia is common and distressing and can lead to increased caregiver burden. However, medications often have adverse reactions and limited effectiveness. Thus, non-pharmacological interventions are being increasingly implemented. To compare and rank the efficacy of differe...

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Bibliographic Details
Published in:International journal of nursing studies 2020-02, Vol.102, p.103489-103489, Article 103489
Main Authors: Leng, Minmin, Zhao, Yajie, Wang, Zhiwen
Format: Article
Language:English
Subjects:
Agitation
Analysis
Animals
Bayesian analysis
Caregiver burden
Caregivers
Clinical medicine
Clinical trials
Critical incidents
Dementia
Efficacy
Health care
Intervention
Massage
Medical personnel
Meta-analysis
Network meta-analysis
Non-pharmacological interventions
Nursing
Systematic review
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Summary:Agitation in people with dementia is common and distressing and can lead to increased caregiver burden. However, medications often have adverse reactions and limited effectiveness. Thus, non-pharmacological interventions are being increasingly implemented. To compare and rank the efficacy of different non-pharmacological interventions in the management of agitation in people with dementia. Bayesian network meta-analysis. A comprehensive electronic literature search was performed in five English databases and three Chinese databases to identify relevant randomized controlled trials (RCTs) that were published up to January 2019. A random-effects model was selected to conduct traditional meta-analysis to directly examine the efficacy of different non-pharmacological interventions. The consistency model was selected to conduct a network meta-analysis to evaluate the relative effects and rank probability of different non-pharmacological interventions. A total of 65 RCTs were included in this network meta-analysis involving 11 different non-pharmacological interventions. Network meta-analysis showed that massage therapy, animal-assisted intervention, and personally tailored intervention were associated with more substantial reductions in agitation compared with other interventions and controls. Our study confirmed the effectiveness of non-pharmacological interventions for ameliorating agitation in people with dementia and recommended several interventions for clinical practice. Healthcare professionals should be encouraged to apply promising non-pharmacological interventions (e.g. massage therapy, animal-assisted intervention and personally tailored intervention) for people with dementia during routine care.
ISSN:0020-7489
1873-491X
DOI:10.1016/j.ijnurstu.2019.103489