Abstract：
To evaluate properties of psychotropic adverse drug event (ADE) monitoring tools intended for use in long-term care facilities.
Systematic review.
Adults aged 18 years and older in nursing homes and other long-term care facilities.
Medline, CINAHL, Embase, and PsycInfo were searched from inception to August 2022 for studies reporting the development, validation, or application of tools to monitor psychotropic ADEs. Screening, data extraction, and quality assessment were performed independently by 2 authors. Each tool was assessed under the domains of test-retest reliability, interrater reliability, content validity, and construct validity.
Eight studies that described 6 tools were included. Tools were developed in Wales (n = 2), United States (n = 1), Ireland (n = 1), Canada (n = 1), and Singapore (n = 1). Tools monitored 4 to 95 items related to antipsychotics (n = 6 tools), antidepressants (n = 4), benzodiazepines or hypnotics (n = 4), antiepileptics (n = 4), and dementia medications (n = 1). Tools commonly monitored sedation, tiredness, or sleepiness (n = 6), falls (n = 4), and tremor or extrapyramidal symptoms (n = 4). Tools were designed for application by nurses (n = 4), during family conferences (n = 1), and by general medical practitioners before repeat prescribing (n = 1). Two tools were reported to require 10 to 60 minutes to administer. Four tools were determined to have adequate content validity and 2 tools adequate interrater reliability. No tools reported test-retest reliability or construct validity.
Six published psychotropic ADE monitoring tools are heterogeneous in design and intended application. Existing tools are predominately designed for application by nurses with or without direct involvement of the wider multidisciplinary team. Further research is needed into models of care that facilitate psychotropic ADE monitoring in the long-term care facility setting, and the extent to which application of specific tools is associated with reduced medication-related harm.
Systematic review.
Adults aged 18 years and older in nursing homes and other long-term care facilities.
Medline, CINAHL, Embase, and PsycInfo were searched from inception to August 2022 for studies reporting the development, validation, or application of tools to monitor psychotropic ADEs. Screening, data extraction, and quality assessment were performed independently by 2 authors. Each tool was assessed under the domains of test-retest reliability, interrater reliability, content validity, and construct validity.
Eight studies that described 6 tools were included. Tools were developed in Wales (n = 2), United States (n = 1), Ireland (n = 1), Canada (n = 1), and Singapore (n = 1). Tools monitored 4 to 95 items related to antipsychotics (n = 6 tools), antidepressants (n = 4), benzodiazepines or hypnotics (n = 4), antiepileptics (n = 4), and dementia medications (n = 1). Tools commonly monitored sedation, tiredness, or sleepiness (n = 6), falls (n = 4), and tremor or extrapyramidal symptoms (n = 4). Tools were designed for application by nurses (n = 4), during family conferences (n = 1), and by general medical practitioners before repeat prescribing (n = 1). Two tools were reported to require 10 to 60 minutes to administer. Four tools were determined to have adequate content validity and 2 tools adequate interrater reliability. No tools reported test-retest reliability or construct validity.
Six published psychotropic ADE monitoring tools are heterogeneous in design and intended application. Existing tools are predominately designed for application by nurses with or without direct involvement of the wider multidisciplinary team. Further research is needed into models of care that facilitate psychotropic ADE monitoring in the long-term care facility setting, and the extent to which application of specific tools is associated with reduced medication-related harm.
摘要：
目的：评估用于长期护理机构的精神药物不良事件（ADE）监测工具的特性。
方法：系统评价。
方法：在养老院和其他长期护理机构中的18岁及以上成年人。
方法：Medline，CINAHL,Embase,和PsycInfo从成立到2022年8月进行了搜索，以获得报告发展的研究，验证,或应用工具来监测精神科ADE。筛选,数据提取,和质量评估由2名作者独立进行。每个工具都在测试-重测可靠性领域进行了评估，评估者间可靠性，内容有效性，并构建效度。
结果：纳入了描述6种工具的8项研究。工具是在威尔士开发的(n=2)，美国（n=1），爱尔兰（n=1），加拿大（n=1），新加坡（n=1）。工具监测了4至95个与抗精神病药相关的项目（n=6个工具），抗抑郁药（n=4），苯二氮卓类药物或催眠药（n=4），抗癫痫药（n=4），和痴呆症药物（n=1）。通常监测镇静的工具，疲倦,或困倦(n=6);跌倒(n=4);和震颤或锥体外系症状(n=4)。工具是为护士设计的(n=4)，在家庭会议期间(n=1)，并在重复处方前由全科医生(n=1)。据报道,两种工具需要10至60分钟来施用。确定了四个工具具有足够的内容有效性和两个工具具有足够的评分者间可靠性。没有工具报告重测信度或结构效度。
结论：6种已发布的精神科ADE监测工具在设计和预期应用方面存在差异。现有的工具主要是为护士在有或没有更广泛的多学科团队直接参与的情况下应用而设计的。需要进一步研究护理模式，以促进长期护理机构环境中的精神ADE监测，以及特定工具的应用与减少药物相关伤害的程度。
方法：系统评价。
方法：在养老院和其他长期护理机构中的18岁及以上成年人。
方法：Medline，CINAHL,Embase,和PsycInfo从成立到2022年8月进行了搜索，以获得报告发展的研究，验证,或应用工具来监测精神科ADE。筛选,数据提取,和质量评估由2名作者独立进行。每个工具都在测试-重测可靠性领域进行了评估，评估者间可靠性，内容有效性，并构建效度。
结果：纳入了描述6种工具的8项研究。工具是在威尔士开发的(n=2)，美国（n=1），爱尔兰（n=1），加拿大（n=1），新加坡（n=1）。工具监测了4至95个与抗精神病药相关的项目（n=6个工具），抗抑郁药（n=4），苯二氮卓类药物或催眠药（n=4），抗癫痫药（n=4），和痴呆症药物（n=1）。通常监测镇静的工具，疲倦,或困倦(n=6);跌倒(n=4);和震颤或锥体外系症状(n=4)。工具是为护士设计的(n=4)，在家庭会议期间(n=1)，并在重复处方前由全科医生(n=1)。据报道,两种工具需要10至60分钟来施用。确定了四个工具具有足够的内容有效性和两个工具具有足够的评分者间可靠性。没有工具报告重测信度或结构效度。
结论：6种已发布的精神科ADE监测工具在设计和预期应用方面存在差异。现有的工具主要是为护士在有或没有更广泛的多学科团队直接参与的情况下应用而设计的。需要进一步研究护理模式，以促进长期护理机构环境中的精神ADE监测，以及特定工具的应用与减少药物相关伤害的程度。
