Evidence map›Paper›PMID 41305862›Full record

ReviewPalliative & supportive care2025

Current evidence of randomized clinical trials on hospice-eligible patients with agitation and dementia: A narrative review.

Olivia YuHsuan Wang, Noam Calev, Jacobo Mintzer, Arianne Fritts, Doris P Molina-Henry, Joshua D Grill, Rema Raman

Abstract readReview
In one paragraph

Review in Palliative & supportive care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Olivia YuHsuan WangLeonard D. Schaeffer Center for Health Policy & Economics, University of Southern California, Los Angeles, CA, USA.ORCID https://orcid.org/0000-0002-6137-6840
Noam CalevMedical University of South Carolina, Charleston, SC, USA.
Jacobo MintzerMedical University of South Carolina, Charleston, SC, USA.
Arianne FrittsMedical University of South Carolina, Charleston, SC, USA.
Doris P Molina-HenryAlzheimer's Therapeutic Research Institute, University of Southern California, San Diego, CA, USA.
Joshua D GrillInstitute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA.
Rema RamanAlzheimer's Therapeutic Research Institute, University of Southern California, San Diego, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAgitation is one of the most distressing behavioral symptoms among hospice-eligible patients with dementia. It compromises patient comfort, increases caregiver burden, and undermines the quality of end-of-life care. Although pharmacologic treatments are frequently used, evidence guiding their safe and effective use in this population remains limited.

objectiveTo identify and synthesize existing randomized controlled trials (RCTs) that evaluated interventions for agitation in hospice-eligible patients with dementia, and to assess the quality and relevance of current evidence.

methodsA narrative review was conducted using systematic search strategies to identify RCTs published between 1990 and 2024 across 8 databases. Studies were included if they (1) focused on hospice-eligible patients with dementia, (2) targeted agitation as a major outcome, and (3) used an RCT design. Studies lacking eligibility criteria, non-RCTs, and non-English articles were excluded.

resultsOf 44 articles screened, only 3 met the inclusion criteria: 2 studies tested nonpharmacological interventions (Namaste and Balancing Arousal Controls Excesses) and 1 tested a pharmacological intervention (sertraline). Results from the nonpharmacological interventions were mixed, and the pharmacologic trial showed no difference between treatment and placebo. Common limitations included small sample sizes, lack of racial and gender diversity, and absence of home-based hospice settings. SIGNIFICANCE OF

resultsThere is a critical gap in high-quality and generalizable evidence to guide agitation management at the end of life for patients with dementia. Addressing this gap is essential to improving not only symptom control but also to preserving dignity and reducing caregiver distress in hospice care. Future trials must include diverse populations, incorporate home-based hospice settings, and rigorously evaluate both pharmacologic and nonpharmacologic interventions to support compassionate, patient-centered care.This review highlights urgent gaps in research and care delivery, underscoring the need for inclusive and scalable intervention designs to address agitation at the end of life.

Indexed as

DementiaHospice CarePsychomotor AgitationRandomized Controlled Trials as TopicHumansagitationdementiaEnd-of-liferandomized controlled trials

Identifiers

PMID41305862
PMCPMC12926728

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.