Evaluating the Clinical Impact of National Dementia Behavior Support Programs on Neuropsychiatric Outcomes in Australia.

Background: People living with dementia (PLWD) in residential aged care homes (RACHs) are frequentlyprescribed psychotropic medications due to the high prevalence of neuropsychiatric symptoms, alsoknown as behaviors and psychological symptoms of dementia (BPSD). However, the gold standard tosupport BPSD is using psychosocial/non-pharmacological therapies. Objective(s): This study aims to describe and evaluate services and neuropsychiatric outcomes associatedwith the provision of psychosocial person-centered care interventions delivered by nationalmultidisciplinary dementia-specific behavior support programs. Method(s): A 2-year retrospective pre-post study with a single-arm analysis was conducted on BPSDreferrals received from Australian RACHs to the two Dementia Support Australia (DSA) programs, theDementia Behavior Management Advisory Service (DBMAS) and the Severe Behavior Response Teams(SBRT). Neuropsychiatric outcomes were measured using the Neuropsychiatric Inventory (NPI) totalscores and total distress scores. The questionnaire version "NPI-Q" was administered for DBMASreferrals whereas the nursing home version "NPI-NH" was administered for SBRT referrals. Linear mixedeffects models were used for analysis, with time, baseline score, age, sex, and case length as predictors.Clinical significance was measured using Cohen's effect size (d; =0.3), the mean change score (MCS; 3points for the NPI-Q and 4 points for the NPI-NH) and the mean percent change (MPC; =30%) in NPIparameters. Result(s): A total of 5,914 referrals (55.9% female, age 82.3 +/- 8.6 y) from 1,996 RACHs were eligible foranalysis. The most common types of dementia were Alzheimer's disease (37.4%) and vascular dementia(11.7%). The average case length in DSA programs was 57.2 +/- 26.3 days. The NPI scores weresignificantly reduced as a result of DSA programs, independent of covariates. There were significantreductions in total NPI scores as a result of the DBMAS (61.4%) and SBRT (74.3%) programs. For