Healthcare Commissioning Forum

Surprisingly little evidence is available on the effectiveness of psychiatric interventions for people with dementia in general hospital settings. Most work has been conducted on how delirium may be managed or prevented in general hospital. Inouye et al showed that a positive strategy of prevention among at-risk medical inpatients, including those with significant cognitive impairment, reduced the incidence of delirium [20]. A randomized controlled trial of a multidisciplinary intervention by a liaison psychiatry team among older medical inpatients in the Netherlands showed that the service improved physical function, reduced length of stay, and reduced admissions to nursing care [21]. The study included people with dementia and adjusting degree of cognitive impairment did not alter the results. Liaison psychiatric services are much advocated for use in general hospital where dementia is so common. Much more research is needed on the efficacy and cost-effectiveness of these services to convince commissioners of their value.

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