Perceptions vs. evidence: therapeutic substitutes for antipsychotics in patients with dementia in long-term care.
Identifieur interne : 000750 ( Main/Exploration ); précédent : 000749; suivant : 000751Perceptions vs. evidence: therapeutic substitutes for antipsychotics in patients with dementia in long-term care.
Auteurs : Brianne L. Olivieri-Mui [États-Unis] ; John W. Devlin [États-Unis] ; Aileen Ochoa [États-Unis] ; Danielle Schenck [États-Unis] ; Becky Briesacher [États-Unis]Source :
- Aging & mental health [ 1364-6915 ] ; 2018.
Descripteurs français
- KwdFr :
- Agents neuromédiateurs (usage thérapeutique), Connaissances, attitudes et pratiques en santé (MeSH), Démence (thérapie), Démence (traitement médicamenteux), Humains (MeSH), Médecins (MeSH), Neuroleptiques (usage thérapeutique), Psychothérapie (méthodes), Soins de longue durée (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH).
- MESH :
- méthodes : Psychothérapie.
- thérapie : Démence.
- traitement médicamenteux : Démence.
- usage thérapeutique : Agents neuromédiateurs, Neuroleptiques.
- Connaissances, attitudes et pratiques en santé, Humains, Médecins, Soins de longue durée, Sujet âgé, Sujet âgé de 80 ans ou plus.
English descriptors
- KwdEn :
- MESH :
- chemical , therapeutic use : Antipsychotic Agents, Neurotransmitter Agents.
- drug therapy : Dementia.
- methods : Psychotherapy.
- therapy : Dementia.
- Aged, Aged, 80 and over, Health Knowledge, Attitudes, Practice, Humans, Long-Term Care, Physicians.
Abstract
OBJECTIVE
To compare differences between clinician perceptions of therapeutic substitutes for antipsychotics prescribed to patients with dementia in long term care (LTC) and published evidence.
METHODS
A mixed-methods approach that included a drug information search, online survey of 55 LTC clinicians and a comprehensive literature review was used. For 41 pharmacologic antipsychotic substitute candidates identified, LTC clinicians rated the likelihood they would substitute each for patients with dementia and identified non-pharmacologic antipsychotic substitutes. The quality of evidence supporting the most likely antipsychotic substitutes was assessed using a modified GRADE approach.
RESULTS
Among 36 (65%) of LTC clinicians responding, the pharmacologic candidates deemed likely or somewhat likely to be substituted for an antipsychotic were: valproic acid, serotonin modulator antidepressants, short-acting benzodiazepines, serotonin reuptake inhibitor antidepressants, alpha-adrenoceptor antagonist, buspirone, acetaminophen, serotonin-norepinephrine reuptake inhibitor antidepressants, memantine, and a cholinesterase inhibitor. High quality evidence supporting these substitutions existed for only memantine and cholinesterase inhibitors, while high quality evidence cautioning against this substitution existed for valproic acid. Activities and music therapy were the most commonly cited non-pharmacologic substitutes but the supporting evidence for each is sparse.
CONCLUSION
Perceptions of LTC clinicians regarding substitutes for antipsychotics in LTC patients with dementia vary widely and are often discordant with published evidence.
DOI: 10.1080/13607863.2016.1277974
PubMed: 28080146
PubMed Central: PMC5547007
Affiliations:
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Devlin</name><affiliation wicri:level="2"><nlm:affiliation>a Department of Pharmacy and Health Systems Sciences, School of Pharmacy , Northeastern University , Boston , MA , USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>a Department of Pharmacy and Health Systems Sciences, School of Pharmacy , Northeastern University , Boston , MA </wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Ochoa, Aileen" sort="Ochoa, Aileen" uniqKey="Ochoa A" first="Aileen" last="Ochoa">Aileen Ochoa</name><affiliation wicri:level="2"><nlm:affiliation>a Department of Pharmacy and Health Systems Sciences, School of Pharmacy , Northeastern University , Boston , MA , USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>a Department of Pharmacy and Health Systems Sciences, School of Pharmacy , Northeastern University , Boston , MA </wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Schenck, Danielle" sort="Schenck, Danielle" uniqKey="Schenck D" first="Danielle" last="Schenck">Danielle Schenck</name><affiliation wicri:level="2"><nlm:affiliation>a Department of Pharmacy and Health Systems Sciences, School of Pharmacy , Northeastern University , Boston , MA , USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>a Department of Pharmacy and Health Systems Sciences, School of Pharmacy , Northeastern University , Boston , MA </wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Briesacher, Becky" sort="Briesacher, Becky" uniqKey="Briesacher B" first="Becky" last="Briesacher">Becky Briesacher</name><affiliation wicri:level="2"><nlm:affiliation>a Department of Pharmacy and Health Systems Sciences, School of Pharmacy , Northeastern University , Boston , MA , USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>a Department of Pharmacy and Health Systems Sciences, School of Pharmacy , Northeastern University , Boston , MA </wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author></analytic><series><title level="j">Aging & mental health</title><idno type="eISSN">1364-6915</idno><imprint><date when="2018" type="published">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Antipsychotic Agents (therapeutic use)</term><term>Dementia (drug therapy)</term><term>Dementia (therapy)</term><term>Health Knowledge, Attitudes, Practice (MeSH)</term><term>Humans (MeSH)</term><term>Long-Term Care (MeSH)</term><term>Neurotransmitter Agents (therapeutic use)</term><term>Physicians (MeSH)</term><term>Psychotherapy (methods)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Agents neuromédiateurs (usage thérapeutique)</term><term>Connaissances, attitudes et pratiques en santé (MeSH)</term><term>Démence (thérapie)</term><term>Démence (traitement médicamenteux)</term><term>Humains (MeSH)</term><term>Médecins (MeSH)</term><term>Neuroleptiques (usage thérapeutique)</term><term>Psychothérapie (méthodes)</term><term>Soins de longue durée (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antipsychotic Agents</term><term>Neurotransmitter Agents</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Dementia</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Psychotherapy</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Psychothérapie</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Dementia</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Démence</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Démence</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Agents neuromédiateurs</term><term>Neuroleptiques</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Health Knowledge, Attitudes, Practice</term><term>Humans</term><term>Long-Term Care</term><term>Physicians</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Connaissances, attitudes et pratiques en santé</term><term>Humains</term><term>Médecins</term><term>Soins de longue durée</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>To compare differences between clinician perceptions of therapeutic substitutes for antipsychotics prescribed to patients with dementia in long term care (LTC) and published evidence.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>A mixed-methods approach that included a drug information search, online survey of 55 LTC clinicians and a comprehensive literature review was used. For 41 pharmacologic antipsychotic substitute candidates identified, LTC clinicians rated the likelihood they would substitute each for patients with dementia and identified non-pharmacologic antipsychotic substitutes. The quality of evidence supporting the most likely antipsychotic substitutes was assessed using a modified GRADE approach.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Among 36 (65%) of LTC clinicians responding, the pharmacologic candidates deemed likely or somewhat likely to be substituted for an antipsychotic were: valproic acid, serotonin modulator antidepressants, short-acting benzodiazepines, serotonin reuptake inhibitor antidepressants, alpha-adrenoceptor antagonist, buspirone, acetaminophen, serotonin-norepinephrine reuptake inhibitor antidepressants, memantine, and a cholinesterase inhibitor. High quality evidence supporting these substitutions existed for only memantine and cholinesterase inhibitors, while high quality evidence cautioning against this substitution existed for valproic acid. Activities and music therapy were the most commonly cited non-pharmacologic substitutes but the supporting evidence for each is sparse.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Perceptions of LTC clinicians regarding substitutes for antipsychotics in LTC patients with dementia vary widely and are often discordant with published evidence.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">28080146</PMID><DateCompleted><Year>2019</Year><Month>08</Month><Day>19</Day></DateCompleted><DateRevised><Year>2019</Year><Month>08</Month><Day>19</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1364-6915</ISSN><JournalIssue CitedMedium="Internet"><Volume>22</Volume><Issue>4</Issue><PubDate><Year>2018</Year><Month>04</Month></PubDate></JournalIssue><Title>Aging & mental health</Title><ISOAbbreviation>Aging Ment Health</ISOAbbreviation></Journal><ArticleTitle>Perceptions vs. evidence: therapeutic substitutes for antipsychotics in patients with dementia in long-term care.</ArticleTitle><Pagination><MedlinePgn>544-549</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1080/13607863.2016.1277974</ELocationID><Abstract><AbstractText Label="OBJECTIVE">To compare differences between clinician perceptions of therapeutic substitutes for antipsychotics prescribed to patients with dementia in long term care (LTC) and published evidence.</AbstractText><AbstractText Label="METHODS">A mixed-methods approach that included a drug information search, online survey of 55 LTC clinicians and a comprehensive literature review was used. For 41 pharmacologic antipsychotic substitute candidates identified, LTC clinicians rated the likelihood they would substitute each for patients with dementia and identified non-pharmacologic antipsychotic substitutes. The quality of evidence supporting the most likely antipsychotic substitutes was assessed using a modified GRADE approach.</AbstractText><AbstractText Label="RESULTS">Among 36 (65%) of LTC clinicians responding, the pharmacologic candidates deemed likely or somewhat likely to be substituted for an antipsychotic were: valproic acid, serotonin modulator antidepressants, short-acting benzodiazepines, serotonin reuptake inhibitor antidepressants, alpha-adrenoceptor antagonist, buspirone, acetaminophen, serotonin-norepinephrine reuptake inhibitor antidepressants, memantine, and a cholinesterase inhibitor. High quality evidence supporting these substitutions existed for only memantine and cholinesterase inhibitors, while high quality evidence cautioning against this substitution existed for valproic acid. Activities and music therapy were the most commonly cited non-pharmacologic substitutes but the supporting evidence for each is sparse.</AbstractText><AbstractText Label="CONCLUSION">Perceptions of LTC clinicians regarding substitutes for antipsychotics in LTC patients with dementia vary widely and are often discordant with published evidence.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Olivieri-Mui</LastName><ForeName>Brianne L</ForeName><Initials>BL</Initials><Identifier Source="ORCID">0000-0001-6739-2019</Identifier><AffiliationInfo><Affiliation>a Department of Pharmacy and Health Systems Sciences, School of Pharmacy , Northeastern University , Boston , MA , USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Devlin</LastName><ForeName>John W</ForeName><Initials>JW</Initials><AffiliationInfo><Affiliation>a Department of Pharmacy and Health Systems Sciences, School of Pharmacy , Northeastern University , Boston , MA , USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ochoa</LastName><ForeName>Aileen</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>a Department of Pharmacy and Health Systems Sciences, School of Pharmacy , Northeastern University , Boston , MA , USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schenck</LastName><ForeName>Danielle</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>a Department of Pharmacy and Health Systems Sciences, School of Pharmacy , Northeastern University , Boston , MA , USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Briesacher</LastName><ForeName>Becky</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>a Department of Pharmacy and Health Systems Sciences, School of Pharmacy , Northeastern University , Boston , MA , USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>R01 AG046341</GrantID><Acronym>AG</Acronym><Agency>NIA NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R21 AG049269</GrantID><Acronym>AG</Acronym><Agency>NIA NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D052061">Research Support, N.I.H., Extramural</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>01</Month><Day>12</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Aging Ment Health</MedlineTA><NlmUniqueID>9705773</NlmUniqueID><ISSNLinking>1360-7863</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D014150">Antipsychotic Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D018377">Neurotransmitter Agents</NameOfSubstance></Chemical></ChemicalList><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014150" MajorTopicYN="N">Antipsychotic Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003704" MajorTopicYN="N">Dementia</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007722" MajorTopicYN="Y">Health Knowledge, Attitudes, Practice</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008134" MajorTopicYN="Y">Long-Term Care</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018377" MajorTopicYN="N">Neurotransmitter Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010820" MajorTopicYN="Y">Physicians</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011613" MajorTopicYN="N">Psychotherapy</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">BPSD</Keyword><Keyword MajorTopicYN="Y">Dementia</Keyword><Keyword MajorTopicYN="Y">antipsychotic</Keyword><Keyword MajorTopicYN="Y">long-term care</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>1</Month><Day>13</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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Olivieri-Mui</name></region><name sortKey="Briesacher, Becky" sort="Briesacher, Becky" uniqKey="Briesacher B" first="Becky" last="Briesacher">Becky Briesacher</name><name sortKey="Devlin, John W" sort="Devlin, John W" uniqKey="Devlin J" first="John W" last="Devlin">John W. Devlin</name><name sortKey="Ochoa, Aileen" sort="Ochoa, Aileen" uniqKey="Ochoa A" first="Aileen" last="Ochoa">Aileen Ochoa</name><name sortKey="Schenck, Danielle" sort="Schenck, Danielle" uniqKey="Schenck D" first="Danielle" last="Schenck">Danielle Schenck</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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