Abstract：
OBJECTIVE: To synthesize recommendations on assessing and managing behavioral and psychological symptoms of dementia (BPSDs) in existing clinical practice guidelines on dementia care to learn from and adapt recommendations to a Canadian context and language for describing BPSDs.
METHODS: Systematic review.
METHODS: Moderate to high-quality clinical practice guidelines on dementia care that made 1 or more recommendations on BPSD assessment or management.
METHODS: We searched MEDLINE, Embase, JBI EBM, PsycINFO, AgeLine, and gray literature for clinical practice guidelines on dementia care making recommendations on BPSD, published between January 1, 2011, and October 13, 2022. Two independent reviewers conducted study screening and data abstraction. Four independent reviewers completed quality appraisal using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool; included guidelines had a mean overall AGREE II score ≥4.
RESULTS: Our systematic review identified 23 moderate to high-quality clinical practice guidelines (264 recommendations). The mean overall quality score on the AGREE II tool ranged from 4 to 6.5. Recommendations were clearly presented (mean clarity of presentation score 73.5%), but guideline applicability was not consistently addressed (mean applicability score 39.3%). BPSD was the most prevalent term describing neuropsychiatric symptoms (number of guidelines [n] = 14). People with lived experience contributed to 6 guidelines (26.1%). Ten guidelines (43.5%) described 1 or more health equity considerations. Guidelines made recommendations for assessing and managing agitation (n = 12), aggression (n = 10), psychosis (n = 11), depression (n = 9), anxiety (n = 5), apathy (n = 6), inappropriate sexual behavior (n = 3), nighttime behavior (n = 5), and eating disturbances (n = 3). There was substantial variability in recommendation statements, evidence quality assigned to each statement, and strength of recommendations.
CONCLUSIONS: There are several moderate to high-quality clinical practice guidelines making recommendations on BPSD assessment and management, but variability in recommendation statements across guidelines and insufficient consideration of guideline applicability may hamper guideline dissemination and implementation in clinical practice.
METHODS: Systematic review.
METHODS: Moderate to high-quality clinical practice guidelines on dementia care that made 1 or more recommendations on BPSD assessment or management.
METHODS: We searched MEDLINE, Embase, JBI EBM, PsycINFO, AgeLine, and gray literature for clinical practice guidelines on dementia care making recommendations on BPSD, published between January 1, 2011, and October 13, 2022. Two independent reviewers conducted study screening and data abstraction. Four independent reviewers completed quality appraisal using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool; included guidelines had a mean overall AGREE II score ≥4.
RESULTS: Our systematic review identified 23 moderate to high-quality clinical practice guidelines (264 recommendations). The mean overall quality score on the AGREE II tool ranged from 4 to 6.5. Recommendations were clearly presented (mean clarity of presentation score 73.5%), but guideline applicability was not consistently addressed (mean applicability score 39.3%). BPSD was the most prevalent term describing neuropsychiatric symptoms (number of guidelines [n] = 14). People with lived experience contributed to 6 guidelines (26.1%). Ten guidelines (43.5%) described 1 or more health equity considerations. Guidelines made recommendations for assessing and managing agitation (n = 12), aggression (n = 10), psychosis (n = 11), depression (n = 9), anxiety (n = 5), apathy (n = 6), inappropriate sexual behavior (n = 3), nighttime behavior (n = 5), and eating disturbances (n = 3). There was substantial variability in recommendation statements, evidence quality assigned to each statement, and strength of recommendations.
CONCLUSIONS: There are several moderate to high-quality clinical practice guidelines making recommendations on BPSD assessment and management, but variability in recommendation statements across guidelines and insufficient consideration of guideline applicability may hamper guideline dissemination and implementation in clinical practice.
摘要：
目的：综合现有痴呆护理临床指南中关于评估和管理痴呆行为和心理症状(BPSD)的建议，以学习和适应加拿大描述BPSD的背景和语言。
方法：系统评价。
方法：关于痴呆症护理的中度至高质量临床实践指南，对BPSD评估或管理提出了1项或多项建议。
方法：我们搜索了MEDLINE，Embase,JBIEBM,PsycINFO,AgeLine,和灰色文献关于痴呆症护理的临床指南，对BPSD提出建议，在2011年1月1日至2022年10月13日之间发布。两名独立的审查员进行了研究筛选和数据抽象。四名独立审查员使用研究与评估指南（AGREE）II工具完成了质量评估；包括的指南的平均总体AGREEII评分≥4。
结果：我们的系统评价确定了23个中、高质量指南（264个建议）。AGREEII工具的平均总体质量评分为4至6.5。建议被清楚地呈现(呈现分数的平均清晰度为73.5%)，但指南适用性未得到一致解决(平均适用性得分为39.3%).BPSD是描述神经精神症状的最普遍的术语(指南数量[n]=14)。有生活经验的人贡献了6个指南（26.1％）。十项指南（43.5%）描述了一种或多种健康公平考虑因素。指南提出了评估和管理躁动的建议(n=12)，侵略（n=10），精神病（n=11），抑郁症（n=9），焦虑（n=5），冷漠(n=6)，不适当的性行为（n=3），夜间行为（n=5），和进食障碍（n=3）。建议声明存在很大差异，分配给每个陈述的证据质量，和建议的强度。
结论：有几个中到高质量的指南对BPSD评估和管理提出了建议，但是不同指南的推荐声明的差异性以及对指南适用性的考虑不足可能会阻碍指南在临床实践中的传播和实施.
方法：系统评价。
方法：关于痴呆症护理的中度至高质量临床实践指南，对BPSD评估或管理提出了1项或多项建议。
方法：我们搜索了MEDLINE，Embase,JBIEBM,PsycINFO,AgeLine,和灰色文献关于痴呆症护理的临床指南，对BPSD提出建议，在2011年1月1日至2022年10月13日之间发布。两名独立的审查员进行了研究筛选和数据抽象。四名独立审查员使用研究与评估指南（AGREE）II工具完成了质量评估；包括的指南的平均总体AGREEII评分≥4。
结果：我们的系统评价确定了23个中、高质量指南（264个建议）。AGREEII工具的平均总体质量评分为4至6.5。建议被清楚地呈现(呈现分数的平均清晰度为73.5%)，但指南适用性未得到一致解决(平均适用性得分为39.3%).BPSD是描述神经精神症状的最普遍的术语(指南数量[n]=14)。有生活经验的人贡献了6个指南（26.1％）。十项指南（43.5%）描述了一种或多种健康公平考虑因素。指南提出了评估和管理躁动的建议(n=12)，侵略（n=10），精神病（n=11），抑郁症（n=9），焦虑（n=5），冷漠(n=6)，不适当的性行为（n=3），夜间行为（n=5），和进食障碍（n=3）。建议声明存在很大差异，分配给每个陈述的证据质量，和建议的强度。
结论：有几个中到高质量的指南对BPSD评估和管理提出了建议，但是不同指南的推荐声明的差异性以及对指南适用性的考虑不足可能会阻碍指南在临床实践中的传播和实施.
