An online toolkit designed to improve crisis support for people with dementia has been welcomed by healthcare staff. However, new research has found that it did not lead to a reduction in psychiatric hospital admissions.

The AQUEDUCT programme aimed to support Teams Managing Crisis in Dementia (TMCDs) through a new toolkit. TMCDs are community-based healthcare teams that support people with dementia and their caregivers during periods of crisis. They aim to help avoid hospital admissions.

The toolkit used in the study included templates, supervision guides and other materials. It aimed to help services deliver more effective crisis care and avoid hospital admissions.

What the study involved

A total of 23 TMCDs across England took part in a trial of the programme between 2021 and 2023. 

The 23 teams were randomly assigned to 2 groups:

  • 11 teams were given the toolkit to use in addition to usual care
  • 12 continued with usual care alone

Over the 6-month study period, researchers monitored psychiatric hospital admissions, staff wellbeing, and satisfaction from people with dementia and their carers.

The findings

The study found no statistically significant difference in psychiatric hospital admissions between teams using the toolkit and those just delivering standard care. 

There were also no differences in wellbeing among people with dementia and carers.

However, despite the lack of impact on hospital admissions, TMCD staff valued the toolkit for helping to standardise practice and support service development. 

There were barriers to teams using the toolkit. Only 5 of 11 TMCDs fully implemented the recommended tools. The others could not use the toolkit due to policy constraints, limited resources. Pressures related to the COVID-19 pandemic also affected its use.

“Potential for improving practice”

Professor Martin Orrell of the University of Nottingham, who led the study, said: 

“While the trial did not find evidence that the toolkit alone reduced psychiatric admissions, it does have potential for improving practice. This suggests it could still play a role in supporting dementia crisis care when combined with stronger implementation strategies.

“The results of this study also highlight the high psychological distress among TMCD staff, underscoring the support these staff need in their day-to-day roles.”

The AQUEDUCT study was led by Nottinghamshire Healthcare NHS Foundation Trust and funded by the National Institute for Health and Care Research (NIHR). 

The paper ‘Achieving Quality and Effectiveness in Dementia Using Crisis Teams (AQUEDUCT): a randomised controlled trial evaluating the impact of a best practice Resource Kit used by teams managing crisis in dementia’ was published in Nature Communications.

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