PDF(Pubmed)
Abstract：
UNASSIGNED: High-quality clinical practice guidelines (CPGs) are important for the effective treatment of behavioral and psychological symptoms of dementia (BPSD). However, recommendations provided by different quality guidelines may lead to varied clinical practice outcomes.
UNASSIGNED: To assess the quality of available CPGs for the management of BPSD and summarize the best recommendations for treating BPSD.
UNASSIGNED: This was a systematic review of CPGs for the management of BPSD with data obtained from electronic databases and evaluated using the Appraisal of Guidelines for Research and Evaluation II instrument, consisting of six domains: \"Scope and purpose\", \"Stakeholder involvement\", \"Rigor of development\", \"Clarity of presentation\", \"Applicability\", and \"Editorial independence\". The criteria for high-quality guidelines were set as: the score of high-quality guidelines in the \"Rigor of development\" domain should be ≥60% and as well as a score of >60% in at least three other domains. High-quality guidelines were selected for recommendation extraction, and the final recommendations were formed in combination with the latest meta-analysis and randomized clinical-trial results.
UNASSIGNED: In term of median scores in each domain for the six included CPGs, \"Scope and purpose\" (87.5%) scored better than all others, whereas \"Applicability\" (46.5%) was the domain with the lowest score. Four CPGs (2015 APA, 2018 NICE, 2018 CANADA, 2020 EAN) met the criteria of high-quality guidelines and were used to extract recommendations. From these four CPGs, nine specific recommendations related to the management of BPSD were summarized, of which seven were related to pharmacological treatment and two to non-pharmacological treatment. These recommendations covered the applicability of antipsychotic drugs, medication recommendations, withdrawal times, and several suitable non-pharmacological therapies.
UNASSIGNED: The quality of CPGs for the management of BPSD requires improvement, especially for the \"Applicability\" domain. For psychotic-like symptoms in dementia, the use of antipsychotics should be based on the individual\'s risk-benefit ratio, and the use of atypical antipsychotics seems to be a better choice. Non-pharmacological treatments may be suitable for emotional symptoms and sleep disorders.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020209204.
UNASSIGNED: To assess the quality of available CPGs for the management of BPSD and summarize the best recommendations for treating BPSD.
UNASSIGNED: This was a systematic review of CPGs for the management of BPSD with data obtained from electronic databases and evaluated using the Appraisal of Guidelines for Research and Evaluation II instrument, consisting of six domains: \"Scope and purpose\", \"Stakeholder involvement\", \"Rigor of development\", \"Clarity of presentation\", \"Applicability\", and \"Editorial independence\". The criteria for high-quality guidelines were set as: the score of high-quality guidelines in the \"Rigor of development\" domain should be ≥60% and as well as a score of >60% in at least three other domains. High-quality guidelines were selected for recommendation extraction, and the final recommendations were formed in combination with the latest meta-analysis and randomized clinical-trial results.
UNASSIGNED: In term of median scores in each domain for the six included CPGs, \"Scope and purpose\" (87.5%) scored better than all others, whereas \"Applicability\" (46.5%) was the domain with the lowest score. Four CPGs (2015 APA, 2018 NICE, 2018 CANADA, 2020 EAN) met the criteria of high-quality guidelines and were used to extract recommendations. From these four CPGs, nine specific recommendations related to the management of BPSD were summarized, of which seven were related to pharmacological treatment and two to non-pharmacological treatment. These recommendations covered the applicability of antipsychotic drugs, medication recommendations, withdrawal times, and several suitable non-pharmacological therapies.
UNASSIGNED: The quality of CPGs for the management of BPSD requires improvement, especially for the \"Applicability\" domain. For psychotic-like symptoms in dementia, the use of antipsychotics should be based on the individual\'s risk-benefit ratio, and the use of atypical antipsychotics seems to be a better choice. Non-pharmacological treatments may be suitable for emotional symptoms and sleep disorders.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020209204.
摘要：
■高质量的临床实践指南（CPG）对于有效治疗痴呆的行为和心理症状（BPSD）非常重要。然而,不同质量指南提供的建议可能导致不同的临床实践结果.
■评估用于管理BPSD的可用CPG的质量，并总结治疗BPSD的最佳建议。
■这是从电子数据库中获得的数据，并使用《研究和评估指南II》工具进行评估，对用于BPSD管理的CPG进行了系统审查。由六个域组成：“范围和目的”，“利益相关者参与”，“发展的严谨”，\"演示文稿的清晰度\",\"适用性\",和“编辑独立性”。高质量指南的标准设置为：“发展的严谨”领域的高质量指南得分应≥60％，以及至少三个其他领域的得分>60％。选择高质量的指南进行推荐提取，最后的建议是结合最新的荟萃分析和随机临床试验结果形成的.
■就包含六个CPG的每个领域的中位数得分而言，“范围和目的”（87.5%）得分优于所有其他人，而“适用性”(46.5%)是得分最低的领域。四个CPG（2015年APA，2018NICE,2018加拿大,2020年EAN)符合高质量指南的标准，并被用来提取建议。从这四个CPG中，总结了与BPSD管理有关的九项具体建议，其中7个与药物治疗有关，2个与非药物治疗有关。这些建议涵盖了抗精神病药物的适用性，用药建议,退出时间,和几种合适的非药物疗法。
■管理BPSD的CPG质量需要改进，特别是对于“适用性”域。对于痴呆症的精神病样症状，抗精神病药物的使用应基于个人的风险收益比，使用非典型抗精神病药似乎是更好的选择。非药物治疗可能适用于情绪症状和睡眠障碍。
■https://www.crd.约克。AC.uk/prospro/display_record.php?ID=CRD42020209204。
■评估用于管理BPSD的可用CPG的质量，并总结治疗BPSD的最佳建议。
■这是从电子数据库中获得的数据，并使用《研究和评估指南II》工具进行评估，对用于BPSD管理的CPG进行了系统审查。由六个域组成：“范围和目的”，“利益相关者参与”，“发展的严谨”，\"演示文稿的清晰度\",\"适用性\",和“编辑独立性”。高质量指南的标准设置为：“发展的严谨”领域的高质量指南得分应≥60％，以及至少三个其他领域的得分>60％。选择高质量的指南进行推荐提取，最后的建议是结合最新的荟萃分析和随机临床试验结果形成的.
■就包含六个CPG的每个领域的中位数得分而言，“范围和目的”（87.5%）得分优于所有其他人，而“适用性”(46.5%)是得分最低的领域。四个CPG（2015年APA，2018NICE,2018加拿大,2020年EAN)符合高质量指南的标准，并被用来提取建议。从这四个CPG中，总结了与BPSD管理有关的九项具体建议，其中7个与药物治疗有关，2个与非药物治疗有关。这些建议涵盖了抗精神病药物的适用性，用药建议,退出时间,和几种合适的非药物疗法。
■管理BPSD的CPG质量需要改进，特别是对于“适用性”域。对于痴呆症的精神病样症状，抗精神病药物的使用应基于个人的风险收益比，使用非典型抗精神病药似乎是更好的选择。非药物治疗可能适用于情绪症状和睡眠障碍。
■https://www.crd.约克。AC.uk/prospro/display_record.php?ID=CRD42020209204。
