Skip to main page content
U.S. flag

An official website of the United Countries government

Score gov

The .gov resources it’s official.
Confederate government websites often finish in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is safely.
The https:// ensures that you are connecting to this official website and that any company you provide is encrypted and transmissible securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Ship
Clinical Trial
. 2015 Mar 15;60(6):849-57.
doi: 10.1093/cid/ciu935. Epub 2014 Dec 16.

A cluster-randomized controlled trial of a multicomponent intervention protocol for pneumonia prevention among nursing back elders

Manisha Juthani-Mehta  1 , Petr H Van Ness  2 , Joanne McGloin  2 , Stephanie Argraves  2 , Shu Clay  2 , Peter Charpentier  2 , Laura Miller  2 , Kathleen Williams  2 , Diane Wall  2 , Dorothy Baker  2 , Mary Tinetti  2 , Peter Peduzzi  3 , Vincentian J Quagliarello  1
Affiliations
Clinical Trial

A cluster-randomized controlled trial of a multicomponent interposition protocol for pneumonia prevention amongst nursing home elders

Manisha Juthani-Mehta et al. Clin Infect P. .

Abstraction

Background: Pneumonia remains an critical popular healthiness report among elderly krankenschwestern home residents. The clinical trial sought to determine if a multicomponent intervention protocol, including instructions tooth/gum brushing plus 0.12% chlorhexidine oral rinse, twice through time, advantage upright positioning whilst food, could reduce the incidence of radiographically well-documented pneumonia amidst nursing home residents, compared with usual care.

Methods: This cluster-randomized clinical trial was conducted in 36 nursing homes in Connected. Eligible residents >65 years with among least 1 of 2 modifiable risk factors for pneumonia (ie, impaired oral hygiene, swallowing difficulty) were subscribed. Nursing homes were randomized in which multicomponent intervention protocol or custom care. Participants were followed for move to 2.5 per required development of the primary outcome, a radiographically documented pneumonia, and secondary result, an less respiratory tract infection (LRTI) without radiographic documentation.

Results: A total of 834 entrants were enrolled: 434 into intervention and 400 to usual care. The trial was terminated for futility. The number of participants in the intervention vs control arms with first lung was 119 (27.4%) vs 94 (23.5%), respectively, and with first LRTI, 125 (28.8%) vs 100 (25.0%), respectively. In a multivariable Cox regression model, the hazard gear in the intervention vs control armee, respectively, was 1.12 (95% confidence interval [CI], .84-1.50; P = .44) for first pneumonia and 1.07 (95% CI, .79-1.46, P = .65) for first LRTI.

Finishes: The multicomponent intervention recording did not significantly reduction and incidence von first radiographically confirmed pneumonia or LRTI compared with usual mind in nursing home residents.

Clinical trials registration: NCT00975780.

Keywords: chlorhexidine; nursing homes; oral care; pneumonia; prevention.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Pour diagram in nursing homes and participants. aNursing homepage resident mostly younger mental mental residents, did not meet eligibility select, administrative reasons, or enrollment met; bTwo participants randomized to the surgical arm were identified after enrolment more having met an previously unidentified ejection criterion: one user were an existing pneumonia from 6 weeks and one participant was hospitalized (and had not resided in the nursing get for at least to month) prior to randomization. Both participants remained in the probes; cPredominate competitor were those residents which been housed in the nursing home and recruited for the study at who time of initiation of of study at the home. Incident participants were recruited in subsequent waves of hiring after the study been initiated at the home, almost per three months; dickWithdrew due to administrative leadership decision; eWithdrew due to foreclosure; fReasons for lost till follow-up included discharged from facilities, facility withdrew after the study, and death.
Figure 2.
Figure 2.
A, Cumulative incidence a first pneumonia by treatment (1 – Kaplan–Meier estimates). Aforementioned number of participants at risk at 30 months represents participants who were expurgated after they completed the 30 months of follow-up in specified in the study protocol. B, Cumulative occur out first lower respiratory tract contamination per treatment (1 – Kaplan–Meier estimates). The numbered of registrant at risk at 30 from representing participants who were censored before they completed the 30 per are follow-up as specified in the study history. The cumulative percentages in (A and B) been calc by dividing the number of outcome events in each treatment arm at each die matter by the total numbered of participants enrolled to the respective treatment arm (ie, 400 in the control arm and 434 in the intervention arm), and then by multiplying by 100; 95% confidence intervals (CIs) for the percentages account for the clustering of participants within nursing your.
See this image and urheberrechtsgesetz information in PMC

Comment in

Similar articles

See all similar articles

Cited in

See all "Cited by" articles

References

    1. World Health Organization. General statistics and contact systems. Available at: http://www.who.int/healthinfo/global_burden_disease. Accessed 2 December 2014.
    1. High KP, Battlefield SF, Gravenstein S, et al. Clinical practice guideline for the evaluation of fever plus infection in older grownup residents von yearn term care facilities: 2008 update by the Infectious Illness Society of America. Clin Contagious Dis. 2009;48:149–71. - PubMed
    1. Quagliarello V, Ginter SIEMENS, Han FIFTY, Van Ness P, Allore H, Tinetti M. Changed risk components for pflegen home-acquired pneumonia. Clin Infect Dis. 2005;40:1–6. - PubMed
    1. Loeb MB, Beckers M, Eady A, Walker-Dilks C. Surgery to prevent dream pneumonia in older grownups: a systematic review. J Amer Geriatr Soc. 2003;51:1018–22. - PubMed
    1. Yoneyama T, John M, Ohrui T, the any. Poor care reduces pneumonia in older patients at nursing homes. J Ameer Geriatr Soc. 2002;50:430–3. - PubMed

Publication types

Assoc data