Table 2 Description of included primary studies for the comparison educational meetings and workshops versus usual care

Fossey

2006 [16]

Health personnel in 6 nursing homes with 181 residents in the intervention group and 6 nursing homes with 168 residents in the control group

Median age: 82 years (range 53-101).

Aimed at reducing the prescribing of neuroleptics for residents with dementia. Ten month educational program delivered by a psychologist, occupational therapist or nurse with a focus on alternatives to drugs for managing agitated behaviour in dementia. The staff received training in providing person centered care and to develop skills through didactic instruction, skills training and weekly supervision and follow up both in groups and individually. The programme entailed a 'systemic consultation approach'.

Extent of implementation: Not reported.

Usual care.

Percentage of residents using neuroleptics, percentage of residents with at least one fall.

Kuske 2009 [19]

Two nursing homes with 89 caregivers and 68 residents allocated to the intervention group and two nursing homes with 94 caregivers and 74 residents allocated to the control group, in Germany.

Mean age: 81 years.

Aimed at increasing the caregivers' knowlegde and competencies for dealing adequately with residents with dementia and reducing the number of residents who were given sedative drugs and/or being physically restrained. A training program that consisted of five modules (13 one hour educational meetings in a 13 week intervention period) was developed using focus groups and review of international literature to find the key problem areas. The aim was to improve the interaction between caregivers and residents by improving caregivers knowledge and expertise in providing care to residents with dementia. Lectures were given by health care researchers with practical experience in nursing in small groups of max 12 participants. Didactic teaching methods were used for the theoretical introduction and problem based learning methods for practical learning and skills training.

Extent of implementation: Caregivers that did not attend at least 10 sessions (i.e. 40% of caregivers) were excluded.

Control 1: A group that was on the waiting list. Control 2: A group of health professionals who received relaxation. This comparison has not been included here.

Percentage of residents using sedative drugs, percentage of residents exposed to physical restraint.

McCallion 1999 [21]

39 nursing assistants in one unit in one nursing home with 49 residents in the intervention group and 49 nursing assistants in one unit in one nursing home with 56 residents in the control group in USA.

Mean age: 84 years.

Aimed at improving the well being of nursing home residents with dementia by means of a communication skills program for nursing assistants. Education delivered by a master's level social worker with practical experience. Alternately group instruction in small groups five times à 45 minutes and individual conferences à 30 minutes four times (for skills training and feedback). The program addressed four areas: knowledge of dementia, verbal and nonverbal communication, memory aids and problem behaviours.

Extent of implementation: Not reported.

Usual care for the control group in the 6 months that the intervention lasted for the experimental group. Then, the control group also received the same intervention for 3 months and both groups were measured again at 9 months (we used data from the 6 month measurements).

Number of days the previous week that residents used psychotropic drugs, number of days the previous week that restraints were used.

Stein 2001 [27]

Health personnel and 76 residents aged 65 years and more taking non steroidal anti-inflammatory drugs (NSAIDs) regularly in 10 nursing homes in the intervention group and 71 residents taking NSAIDs regularly in 10 nursing homes in the control group in USA.

Age: ≥65 years.

Aimed at reducing the use of NSAIDs in the management of osteoarthritis in nursing home residents. The educational programme focused on alternative approaches to NSAIDs to relieve muscle and joint pains in residents, e.g. use of acetaminophen. One meeting with both the administrative and professional management and a separate meeting with each nursing home study coordinator to review the purpose and educational materials during the initial phase of the project, a 30 minute structured teaching session for physicians and nursing staff.

Extent of implementation: On average, in each nursing home it was estimated that 60-65% of all staff received the educational programme.

Usual care

Use of NSAIDs and acetaminophen the past seven days.

Testad 2010 [30]

197 care staff. Two nursing homes with 113 residents in the intervention group and two nursing homes with 98 residents in control.

Median age 86 years.

Aimed at reducing agitation in residents with dementia, use of restraints and antipsychotic drugs. Relation Related Care education and training program, consisting of predisposing, enabling and reinforcing elements. Organized as a two day seminar and monthly group guidance for six months.

Extent of implementation: "All care staff with and without formal education, including leaders and domestic staff, participated... [...] During the study period, there was considerable turnover of staff...": 56 (54%) remained in intervention and 53 (57%) in the control group.

Usual practice.

Percentage of residents taking antipsychotic drugs, use of restraint.