PDF(Pubmed)
Abstract：
UNASSIGNED: Adults with intellectual disabilities have an increased vulnerability to mental health problems and challenging behaviour. In addition to psychotherapeutic or psychoeducational methods, off-label pharmacotherapy, is a commonly used treatment modality.
UNASSIGNED: The aim of this study was to establish evidence-based guideline recommendations for the responsible prescription of off-label psychotropic drugs, in relation to Quality of Life (QoL).
UNASSIGNED: A list of guidelines was selected, and principles were established based on international literature, guideline review and expert evaluation. The Delphi method was used to achieve consensus about guideline recommendations among a 58-member international multidisciplinary expert Delphi panel. Thirty-three statements were rated on a 5-point Likert-scale, ranging from totally disagree to totally agree, in consecutive Delphi rounds. When at least 70% of the participants agreed (score equal or higher than 4), a statement was accepted . Statements without a consensus were adjusted between consecutive Delphi rounds based on feedback from the Delphi panel.
UNASSIGNED: Consensus was reached on 4 general:the importance of non-pharmaceutical treatments, comprehensive diagnostics and multidisciplinary treatment. Consensus was reached in 4 rounds on 29 statements. No consensus was reached on 4 statements concerning: freedom-restricting measures, the treatment plan, the evaluation of the treatment plan, and the informed consent.
UNASSIGNED: The study led to recommendations and principles for the responsible prescription - aligned with the QoL perspective - of off-label psychotropic drugs for adults with intellectual disabilities and challenging behaviour. Extensive discussion is needed regarding the issues on which there was no consensus to furthering the ongoing development of this guideline.
UNASSIGNED: The aim of this study was to establish evidence-based guideline recommendations for the responsible prescription of off-label psychotropic drugs, in relation to Quality of Life (QoL).
UNASSIGNED: A list of guidelines was selected, and principles were established based on international literature, guideline review and expert evaluation. The Delphi method was used to achieve consensus about guideline recommendations among a 58-member international multidisciplinary expert Delphi panel. Thirty-three statements were rated on a 5-point Likert-scale, ranging from totally disagree to totally agree, in consecutive Delphi rounds. When at least 70% of the participants agreed (score equal or higher than 4), a statement was accepted . Statements without a consensus were adjusted between consecutive Delphi rounds based on feedback from the Delphi panel.
UNASSIGNED: Consensus was reached on 4 general:the importance of non-pharmaceutical treatments, comprehensive diagnostics and multidisciplinary treatment. Consensus was reached in 4 rounds on 29 statements. No consensus was reached on 4 statements concerning: freedom-restricting measures, the treatment plan, the evaluation of the treatment plan, and the informed consent.
UNASSIGNED: The study led to recommendations and principles for the responsible prescription - aligned with the QoL perspective - of off-label psychotropic drugs for adults with intellectual disabilities and challenging behaviour. Extensive discussion is needed regarding the issues on which there was no consensus to furthering the ongoing development of this guideline.
摘要：
■患有智力障碍的成年人对心理健康问题和挑战性行为的脆弱性增加。除了心理治疗或心理教育方法，标签外药物治疗，是一种常用的治疗方式。
■这项研究的目的是建立基于证据的指导建议，以负责任地处方标签外的精神药物，与生活质量(QoL)相关。
■选择了指南列表，和原则是根据国际文献建立的，指南审查和专家评估。使用Delphi方法在由58名成员组成的国际多学科专家Delphi小组中就指南建议达成共识。三十三份陈述以5分利克特量表进行了评级，从完全不同意到完全同意，在连续的德尔福回合中。当至少70％的参与者同意（得分等于或高于4）时，一份声明被接受。根据Delphi小组的反馈，在连续的Delphi轮之间调整了未达成共识的陈述。
■就4个一般性问题达成共识：非药物治疗的重要性，综合诊断和多学科治疗。就29项声明分4轮达成了共识。关于限制自由措施、治疗计划,治疗计划的评估，和知情同意。
■该研究提出了与QoL观点相一致的负责任处方的建议和原则，用于智障和具有挑战性行为的成年人的标签外精神药物。需要就尚未达成共识的问题进行广泛讨论，以促进该准则的持续发展。
■这项研究的目的是建立基于证据的指导建议，以负责任地处方标签外的精神药物，与生活质量(QoL)相关。
■选择了指南列表，和原则是根据国际文献建立的，指南审查和专家评估。使用Delphi方法在由58名成员组成的国际多学科专家Delphi小组中就指南建议达成共识。三十三份陈述以5分利克特量表进行了评级，从完全不同意到完全同意，在连续的德尔福回合中。当至少70％的参与者同意（得分等于或高于4）时，一份声明被接受。根据Delphi小组的反馈，在连续的Delphi轮之间调整了未达成共识的陈述。
■就4个一般性问题达成共识：非药物治疗的重要性，综合诊断和多学科治疗。就29项声明分4轮达成了共识。关于限制自由措施、治疗计划,治疗计划的评估，和知情同意。
■该研究提出了与QoL观点相一致的负责任处方的建议和原则，用于智障和具有挑战性行为的成年人的标签外精神药物。需要就尚未达成共识的问题进行广泛讨论，以促进该准则的持续发展。
