TIME (English Version)
Targeted Interdisciplinary Model for Evaluation and treatment of neuropsychiatric symptoms
TIME is a multicomponent intervention to be used by the nursing home staff and physicians, for the assessment and treatment of behavioural and psychological symptoms in dementia or other complex disorders. These symptoms are also called neuropsychiatric symptoms or sometimes challenging behaviour. The intervention is based on principles and structures from cognitive behavioural therapy and from person-centred care. The aim is to customize measures for the individual patient.
The TIME manual is a short and practical aid to carrying out TIME. It gives a step-by-step description of how to implement the intervention model.
Link to the TIME manual: TIME Manual
Link to the educational film about TIME: TIME Film
The TIME study is a three-month cluster randomized trial conducted from January 2016 in 33 Norwegian nursing homes, assigning 229 patients with dementia and moderate to high levels of agitation to receive either the Targeted Interdisciplinary Model for Evaluation and Treatment of Neuropsychiatric Symptoms (TIME) or a brief education-only intervention. We will also perform a systematic process evaluation during the study as outlined in the trial protocol. This evaluation at the staff and organization level will continue for one year to measure the degree of implementation and sustainability of the intervention.
Link to the TIME study protocol published in BMC Psychiatry: Study Protocol for the TIME-trial
Link to the TIME-trial, a randomized controlled trial, showing results of effectiveness of the intervention with TIME in nursing homes. This paper was published in the American Journal of Geriatric Psychiatry, 2017. In this trial agitation was measured by the singel-item agitation in the Neuropsychiatric Inventory – Nursing Home Version (NPI-NH). A significant between-group difference in reduction of agitation at both eight weeks (1.1; 95% confidence interval, 0.1 to 2.1; P=0.03) and 12 weeks (1.6; 95% confidence interval, 0.6 to 2.7; P=0.002) in favour of the TIME intervention was found. Symptoms of delusions at eight weeks, and depression, disinhibition, and quality of life at 12 weeks, showed significant between-group differences in favour of the TIME intervention.
The TIME trial is funded by the Innlandet Hospital Trust
The TIME project has been supported by:
Innlandet Hospital Trust, Norway; The Center for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad Norway; The Norwegian Medical Association fund for quality and patient safety; The Municipality of Rana, Norway; and the National Centre of Rural Medicine (NCRM) The artic University of Norway,Tromsø (UiT).
Bjørn Lichtwarck, MD/researcher, firstname.lastname@example.org
Janne Myhre, M.Sc.,Nurse Specialist in Psychiatry and Geriatrics, email@example.com
Both at the Centre for Old Age Psychiatric Research, Innlandet Hospital Trust