Abstract：
Aripiprazole is a second-generation antipsychotic, efficacious in patients with schizophrenia during acute episodes. Due to its pharmacological profile, aripiprazole may be of interest in patients with specific clinical profiles who have not been studied extensively in randomised clinical trials.
To capture experience with aripiprazole in everyday psychiatric practice using the Delphi method in order to inform decision-making on the use of aripiprazole for the treatment of patients with schizophrenia in clinical situations where robust evidence from clinical trials is lacking.
The scope of the survey was defined as the management of schizophrenia in adults. A systematic literature review was performed to identify the different clinical situations in which aripiprazole has been studied, and to describe the level of clinical evidence. Clinical profiles to include in the Delphi survey were selected if there was a clear interest in terms of medical need but uncertainty over the efficacy of aripiprazole. For each clinical profile retained, five to seven specific statements were generated and included in a questionnaire. The final 41-item questionnaire was proposed to a panel of 406 French psychiatrists with experience in the treatment of schizophrenia. Panellists rated their level of agreement using a Likert scale. A second round of voting on eleven items was organised to clarify points for which a consensus was not obtained in the first round.
Five clinical profiles were identified in the literature review (persistent negative symptoms, pregnancy, cognitive dysfunction, addictive comorbidity and clozapine resistance). Sixty-two psychiatrists participated in the first round of the Delphi survey and 33 in the second round. A consensus was obtained for 11 out of 41 items in the first round and for 9/11 items in the second round. According to the panellists\' clinical experience, aripiprazole can be used as maintenance treatment for pregnant women, is relevant to preserve cognitive function and can be considered an option in patients with a comorbid addictive disorder or with persistent negative symptoms.
These findings may help physicians in choosing relevant ways to use aripiprazole and highlight areas where more research is needed to widen the evidence base.
To capture experience with aripiprazole in everyday psychiatric practice using the Delphi method in order to inform decision-making on the use of aripiprazole for the treatment of patients with schizophrenia in clinical situations where robust evidence from clinical trials is lacking.
The scope of the survey was defined as the management of schizophrenia in adults. A systematic literature review was performed to identify the different clinical situations in which aripiprazole has been studied, and to describe the level of clinical evidence. Clinical profiles to include in the Delphi survey were selected if there was a clear interest in terms of medical need but uncertainty over the efficacy of aripiprazole. For each clinical profile retained, five to seven specific statements were generated and included in a questionnaire. The final 41-item questionnaire was proposed to a panel of 406 French psychiatrists with experience in the treatment of schizophrenia. Panellists rated their level of agreement using a Likert scale. A second round of voting on eleven items was organised to clarify points for which a consensus was not obtained in the first round.
Five clinical profiles were identified in the literature review (persistent negative symptoms, pregnancy, cognitive dysfunction, addictive comorbidity and clozapine resistance). Sixty-two psychiatrists participated in the first round of the Delphi survey and 33 in the second round. A consensus was obtained for 11 out of 41 items in the first round and for 9/11 items in the second round. According to the panellists\' clinical experience, aripiprazole can be used as maintenance treatment for pregnant women, is relevant to preserve cognitive function and can be considered an option in patients with a comorbid addictive disorder or with persistent negative symptoms.
These findings may help physicians in choosing relevant ways to use aripiprazole and highlight areas where more research is needed to widen the evidence base.
摘要：
阿立哌唑是第二代抗精神病药物,在精神分裂症患者急性发作期间有效。由于其药理作用，阿立哌唑可能对具有特定临床特征且在随机临床试验中未进行广泛研究的患者感兴趣.
使用Delphi方法获取阿立哌唑在日常精神病学实践中的经验，以便在缺乏临床试验有力证据的临床情况下决策使用阿立哌唑治疗精神分裂症患者。
调查范围定义为成人精神分裂症的管理。进行了系统的文献综述，以确定研究阿立哌唑的不同临床情况。并描述临床证据的水平。如果对医疗需求有明确的兴趣，但对阿立哌唑的疗效不确定，则选择包括在Delphi调查中的临床资料。对于保留的每个临床资料，生成了5至7项具体陈述,并将其纳入问卷.最后的41项问卷是向具有精神分裂症治疗经验的406名法国精神科医生组成的小组提出的。小组成员使用李克特量表对他们的协议水平进行了评级。对11个项目进行了第二轮投票，以澄清第一轮未达成共识的要点。
在文献综述中发现了五种临床特征(持续的阴性症状，怀孕,认知功能障碍，成瘾性共病和氯氮平耐药性)。62名精神科医生参加了第一轮德尔福调查，33名参加了第二轮调查。第一轮对41个项目中的11个达成了共识，第二轮对9/11个项目达成了共识。根据小组成员的临床经验，阿立哌唑可以作为孕妇的维持治疗，与保持认知功能相关，并且可以被认为是患有共病成瘾或持续阴性症状的患者的一种选择。
这些发现可能有助于医生选择使用阿立哌唑的相关方法，并强调需要更多研究来扩大证据基础的领域。
使用Delphi方法获取阿立哌唑在日常精神病学实践中的经验，以便在缺乏临床试验有力证据的临床情况下决策使用阿立哌唑治疗精神分裂症患者。
调查范围定义为成人精神分裂症的管理。进行了系统的文献综述，以确定研究阿立哌唑的不同临床情况。并描述临床证据的水平。如果对医疗需求有明确的兴趣，但对阿立哌唑的疗效不确定，则选择包括在Delphi调查中的临床资料。对于保留的每个临床资料，生成了5至7项具体陈述,并将其纳入问卷.最后的41项问卷是向具有精神分裂症治疗经验的406名法国精神科医生组成的小组提出的。小组成员使用李克特量表对他们的协议水平进行了评级。对11个项目进行了第二轮投票，以澄清第一轮未达成共识的要点。
在文献综述中发现了五种临床特征(持续的阴性症状，怀孕,认知功能障碍，成瘾性共病和氯氮平耐药性)。62名精神科医生参加了第一轮德尔福调查，33名参加了第二轮调查。第一轮对41个项目中的11个达成了共识，第二轮对9/11个项目达成了共识。根据小组成员的临床经验，阿立哌唑可以作为孕妇的维持治疗，与保持认知功能相关，并且可以被认为是患有共病成瘾或持续阴性症状的患者的一种选择。
这些发现可能有助于医生选择使用阿立哌唑的相关方法，并强调需要更多研究来扩大证据基础的领域。
