Non-pharmacological interventions to reduce restrictive practices in adult mental health inpatient settings: the COMPARE systematic mapping review

• DOI: 10.3310/hsdr09050
• Publication Date: 2021-03-01T15:45:27Z
• Authors: John Baker; Kathryn Berzins; Krysia Canvin; Iris Benson; Ian Kellar; Judy Wright; Rocio Rodriguez L...; Joy Duxbury; Tim Kendall; Duncan Stewart
• Keywords: PsycINFO; CINAHL; Grey Literature

Objectives The study aimed to provide a mapping review of non-pharmacological interventions reduce restrictive practices in adult mental health inpatient settings; classify intervention components using the behaviour change technique taxonomy; explore evidence techniques and interventions; identify that show most effectiveness those require further testing. Background Incidents involving violence aggression occur frequently settings. They often result such as restraint seclusion. These carry significant risks, including physical psychological harm service users staff, costs NHS. A number aim use by modify practice. Some have been evaluated, but research is hampered limited attention specific components. taxonomy provides common language with which specify content. Design Systematic analysis. Data sources English-language social care databases, grey literature, media. databases searched included British Nursing Index (BNI), Cumulative Allied Health Literature (CINAHL), Cochrane Central Register Controlled Trials (CCRCT), Database Reviews (CDSR), Abstracts Effects (DARE), EMBASE, Technology Assessment (HTA) Database, HTA Canadian International, Ovid MEDLINE ® , NHS Economic Evaluation (NHS EED), PsycInfo PubMed. Databases were from 1999 2019. Review methods Broad literature search; identification, description classification quality appraisal reports. Records any form practice used adults services retrieved subject scrutiny content, appraisal, Mixed Methods Appraisal Tool; data extraction, regarding whether participants staff or users, participants, setting, type, procedures fidelity. resulting set for extraction was guided Workgroup Intervention Development Research, theory coding scheme recommendations. applied systematically each identified intervention. examined overarching patterns, range frequency. Overall percentages cluster reported. Procedures within interventions, example training, described taxonomy. Results final comprised 221 records reporting 150 109 had evaluated. evaluation approach non-randomised design. There six randomised controlled trials. Behaviour 14 out possible 16 clusters detected. found likely be demonstrated statistically effects. target seclusion reduction. strategy training. Over two-thirds mapped onto four clusters, ‘goals planning’, ‘antecedents’, ‘shaping knowledge’ ‘feedback monitoring’. per ranged 1 33 (mean 8 techniques). Limitations Many poorly might contained additional not finding weak restricted study’s scope examining effectiveness. search records. Conclusions Studies on appear diverse poor. Interventions tend contain multiple delivered ways. Future work Prior future commissioning decisions, enhance base could help address urgent need effective strategies. Testing individual procedures, example, audit feedback, ascertain are Separate testing improve understanding content delivery. Study registration registered PROSPERO CRD42018086985. Funding This project funded National Institute Research (NIHR) Services Delivery programme will published full ; Vol. 9, No. 5. See NIHR Journals Library website information.