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Abstract：
Behavioral and psychological symptoms of dementia (BPSD) are difficult to manage and associated with poor outcome.
The aim of this study was to reach consensus on the use of antipsychotics in patients with BPSD in Spain.
A qualitative, multicenter, two-round Delphi study was carried out, with the participation of specialists involved in the care of dementia patients throughout Spain. They completed a 76-item questionnaire related to the identification of BPSD, treatment with antipsychotics, follow-up of patients, barriers for the use of atypical antipsychotics, and effects of antipsychotics on quality of life.
A total of 162 specialists in neurology, psychiatry, and geriatrics (61% men) with a mean (SD) age of 45.9 (10) years participated in the study. Almost all participants (96.9%) strongly agreed that atypical antipsychotics are safer and better tolerated than typical antipsychotics. There was agreement on the importance to review the indication and dose of the antipsychotic drug at least every 3 months. There was consistent high rate of agreement on the beneficial impact of atypical antipsychotics on the quality of life of patients with dementia and their caregivers. A consensus was also reached on the need of detecting BPSD in patients with dementia as it decreases the quality of life of both patients and caregivers, and the need to routinely screen for dementia in elderly patients with no previous psychiatric history in the presence of suggestive symptoms of BPSD. Finally, the participants in the study agreed that administrative barriers for the prescription of atypical antipsychotics in Spain hinder the access to this drug group and favor the prescription of typical antipsychotics.
The participants in the study agreed that atypical antipsychotics should be preferred to typical antipsychotics in the management of BPSD. Wide consensus was reached about the importance of early identification of BPSD in persons with cognitive impairment, the use and management of atypical antipsychotic drugs and their favorable impact on patients and caregiver\'s quality of life.
The aim of this study was to reach consensus on the use of antipsychotics in patients with BPSD in Spain.
A qualitative, multicenter, two-round Delphi study was carried out, with the participation of specialists involved in the care of dementia patients throughout Spain. They completed a 76-item questionnaire related to the identification of BPSD, treatment with antipsychotics, follow-up of patients, barriers for the use of atypical antipsychotics, and effects of antipsychotics on quality of life.
A total of 162 specialists in neurology, psychiatry, and geriatrics (61% men) with a mean (SD) age of 45.9 (10) years participated in the study. Almost all participants (96.9%) strongly agreed that atypical antipsychotics are safer and better tolerated than typical antipsychotics. There was agreement on the importance to review the indication and dose of the antipsychotic drug at least every 3 months. There was consistent high rate of agreement on the beneficial impact of atypical antipsychotics on the quality of life of patients with dementia and their caregivers. A consensus was also reached on the need of detecting BPSD in patients with dementia as it decreases the quality of life of both patients and caregivers, and the need to routinely screen for dementia in elderly patients with no previous psychiatric history in the presence of suggestive symptoms of BPSD. Finally, the participants in the study agreed that administrative barriers for the prescription of atypical antipsychotics in Spain hinder the access to this drug group and favor the prescription of typical antipsychotics.
The participants in the study agreed that atypical antipsychotics should be preferred to typical antipsychotics in the management of BPSD. Wide consensus was reached about the importance of early identification of BPSD in persons with cognitive impairment, the use and management of atypical antipsychotic drugs and their favorable impact on patients and caregiver\'s quality of life.
摘要：
痴呆的行为和心理症状(BPSD)难以管理并且与不良结果相关。
本研究的目的是就西班牙BPSD患者使用抗精神病药物达成共识。
定性的，多中心，进行了两轮Delphi研究，参与整个西班牙痴呆症患者护理的专家的参与。他们完成了一份涉及识别BPSD的76项问卷，用抗精神病药物治疗，患者随访,使用非典型抗精神病药的障碍，以及抗精神病药物对生活质量的影响。
共有162名神经病学专家，精神病学,和老年病科（61％的男性），平均（SD）年龄为45.9（10）岁。几乎所有参与者（96.9%）都强烈同意非典型抗精神病药物比典型抗精神病药物更安全，耐受性更好。就至少每3个月审查抗精神病药物的适应症和剂量的重要性达成共识。关于非典型抗精神病药物对痴呆症患者及其护理人员的生活质量的有益影响，存在一致的高共识率。在痴呆症患者中检测BPSD的必要性也达成了共识，因为它会降低患者和护理人员的生活质量。并且需要在没有精神病史的老年患者中，在提示有BPSD症状的情况下，常规筛查痴呆症。最后,该研究的参与者一致认为,西班牙非典型抗精神病药物处方的行政障碍阻碍了该药物组的获得,并有利于典型抗精神病药物的处方.
该研究的参与者一致认为，在BPSD的治疗中，非典型抗精神病药物应优于典型抗精神病药物。在认知障碍患者中早期识别BPSD的重要性达成了广泛共识，非典型抗精神病药物的使用和管理及其对患者和护理人员生活质量的有利影响。
本研究的目的是就西班牙BPSD患者使用抗精神病药物达成共识。
定性的，多中心，进行了两轮Delphi研究，参与整个西班牙痴呆症患者护理的专家的参与。他们完成了一份涉及识别BPSD的76项问卷，用抗精神病药物治疗，患者随访,使用非典型抗精神病药的障碍，以及抗精神病药物对生活质量的影响。
共有162名神经病学专家，精神病学,和老年病科（61％的男性），平均（SD）年龄为45.9（10）岁。几乎所有参与者（96.9%）都强烈同意非典型抗精神病药物比典型抗精神病药物更安全，耐受性更好。就至少每3个月审查抗精神病药物的适应症和剂量的重要性达成共识。关于非典型抗精神病药物对痴呆症患者及其护理人员的生活质量的有益影响，存在一致的高共识率。在痴呆症患者中检测BPSD的必要性也达成了共识，因为它会降低患者和护理人员的生活质量。并且需要在没有精神病史的老年患者中，在提示有BPSD症状的情况下，常规筛查痴呆症。最后,该研究的参与者一致认为,西班牙非典型抗精神病药物处方的行政障碍阻碍了该药物组的获得,并有利于典型抗精神病药物的处方.
该研究的参与者一致认为，在BPSD的治疗中，非典型抗精神病药物应优于典型抗精神病药物。在认知障碍患者中早期识别BPSD的重要性达成了广泛共识，非典型抗精神病药物的使用和管理及其对患者和护理人员生活质量的有利影响。
