The Effectiveness and Feasibility of Non-Pharmacological Interventions for Reducing Behavioural and Psychosocial Symptoms of Dementia and Improving Patient Experience in Acute Care Settings: A Systematic Review

This review aimed to evaluate the effectiveness and feasibility of non-pharmacological interventions to reduce anxiety and agitation and improve observable wellbeing and patient engagement for people with dementia in acute hospital environments. The global increase in dementia has resulted in a substantial number of acute hospital beds occupied by people with dementia. Hospitalisation can exacerbate behavioural and psychosocial symptoms of dementia (BPSD) including anxiety and agitation, which negatively affects patient experience, safety and care. Clinical guidance recommends non-pharmacological interventions as a first-line tactic to manage BPSD. However, evidence for the effectiveness and feasibility of these interventions remains fragmented in such pressured environments. A systematic search of seven databases was conducted for studies published in the last ten years (2015–25), following the PRISMA guidelines. Fourteen studies met the eligibility criteria and included a total of 749 people with dementia. Studies used mixed interventions; music, music therapy and person-centred care highly featured and most studies reported reductions in observable BPSD during or immediately after interventions. Secondary benefits included wellbeing, reduced psychotropic medicine use, length of hospitalisation and high staff and patient acceptability. There was limited evidence for sustained effects beyond intervention. This review supports the feasibility and effectiveness of non-pharmacological interventions in acute hospitals to support dementia-inclusive, person-centred care.