Abstract：
OBJECTIVE: To produce a consensus list of the top 10 signs and symptoms suggestive of adverse drug events (ADEs) for monitoring in residents of long-term care facilities (LTCFs) who use antipsychotics, benzodiazepines, or antidepressants.
METHODS: A 3-round Delphi study.
METHODS: Geriatricians, psychiatrists, pharmacologists, general practitioners, pharmacists, nurses, and caregivers from 13 Asia Pacific, European, and North American countries.
METHODS: Three survey rounds were completed between April and June 2023. In Round 1, participants indicated their level of agreement on a 9-point Likert scale on whether 41 signs or symptoms identified in a systematic review should be routinely monitored. Participants considered signs and symptoms that reduce quality of life or cause significant harm, are observable or measurable by nurses or care workers, and can be assessed at a single time point. Round 1 statements were included in a list for prioritization in Round 3 if ≥ 70% of participants responded ≥7 on the Likert scale. Statements were excluded if ≤ 30% of participants responded ≥7. In Round 2, participants indicated their level of agreement with statements that did not reach initial consensus, plus amended statements based on Round 1 participant feedback. Round 2 statements were included in Round 3 if ≥ 50% of the participants responded ≥7 on the Likert scale. In Round 3, participants prioritized the signs and symptoms.
RESULTS: Forty-four participants (93.6%) completed all 3 rounds. Four of 41 signs and symptoms reached consensus for inclusion after Round 1, and 9 after Round 2. The top 10 signs and symptoms prioritized in Round 3 were recent falls, daytime drowsiness or sleepiness, abnormal movements (eg, shaking or stiffness), confusion or disorientation, balance problems, dizziness, postural hypotension, reduced self-care, restlessness, and dry mouth.
CONCLUSIONS: The top 10 signs and symptoms provide a basis for proactive monitoring for psychotropic ADEs.
METHODS: A 3-round Delphi study.
METHODS: Geriatricians, psychiatrists, pharmacologists, general practitioners, pharmacists, nurses, and caregivers from 13 Asia Pacific, European, and North American countries.
METHODS: Three survey rounds were completed between April and June 2023. In Round 1, participants indicated their level of agreement on a 9-point Likert scale on whether 41 signs or symptoms identified in a systematic review should be routinely monitored. Participants considered signs and symptoms that reduce quality of life or cause significant harm, are observable or measurable by nurses or care workers, and can be assessed at a single time point. Round 1 statements were included in a list for prioritization in Round 3 if ≥ 70% of participants responded ≥7 on the Likert scale. Statements were excluded if ≤ 30% of participants responded ≥7. In Round 2, participants indicated their level of agreement with statements that did not reach initial consensus, plus amended statements based on Round 1 participant feedback. Round 2 statements were included in Round 3 if ≥ 50% of the participants responded ≥7 on the Likert scale. In Round 3, participants prioritized the signs and symptoms.
RESULTS: Forty-four participants (93.6%) completed all 3 rounds. Four of 41 signs and symptoms reached consensus for inclusion after Round 1, and 9 after Round 2. The top 10 signs and symptoms prioritized in Round 3 were recent falls, daytime drowsiness or sleepiness, abnormal movements (eg, shaking or stiffness), confusion or disorientation, balance problems, dizziness, postural hypotension, reduced self-care, restlessness, and dry mouth.
CONCLUSIONS: The top 10 signs and symptoms provide a basis for proactive monitoring for psychotropic ADEs.
摘要：
目的：为使用抗精神病药物的长期护理机构（LTCFs）的居民提供一份关于药物不良事件（ADE）的十大体征和症状的共识清单，苯二氮卓类药物,或者抗抑郁药.
方法：3轮德尔菲研究。
方法：老年医生，精神病医生,药理学家,全科医生,药剂师,护士,和来自13个亚太地区的护理人员，欧洲,和北美国家。
方法：在2023年4月至6月之间完成了三轮调查。在第1轮中，参与者表示了他们对9点李克特量表的共识水平，即是否应常规监测系统审查中确定的41种体征或症状。参与者考虑了降低生活质量或造成重大伤害的体征和症状，可由护士或护理人员观察或测量，并且可以在单个时间点进行评估。如果≥70％的参与者在李克特量表上回答≥7，则第1轮陈述将包括在第3轮的优先级列表中。如果≤30%的参与者回答≥7，则排除陈述。在第二轮中，与会者表示了他们对没有达成初步共识的声明的一致意见，加上基于第一轮参与者反馈的修改声明。如果≥50％的参与者在李克特量表上回答≥7，则将第2轮陈述纳入第3轮。在第3轮中，参与者优先考虑体征和症状。
结果：44名参与者（93.6％）完成了所有3轮比赛。41种体征和症状中的4种在第1轮之后达成共识，9种在第2轮之后达成共识。第3轮中最优先考虑的10种体征和症状是最近的跌倒，白天嗜睡或嗜睡，异常运动(例如，晃动或刚度)，困惑或迷失方向，平衡问题,头晕,体位性低血压,减少自我照顾，躁动,口干。
结论：前10种体征和症状为主动监测精神型ADE提供了依据。
方法：3轮德尔菲研究。
方法：老年医生，精神病医生,药理学家,全科医生,药剂师,护士,和来自13个亚太地区的护理人员，欧洲,和北美国家。
方法：在2023年4月至6月之间完成了三轮调查。在第1轮中，参与者表示了他们对9点李克特量表的共识水平，即是否应常规监测系统审查中确定的41种体征或症状。参与者考虑了降低生活质量或造成重大伤害的体征和症状，可由护士或护理人员观察或测量，并且可以在单个时间点进行评估。如果≥70％的参与者在李克特量表上回答≥7，则第1轮陈述将包括在第3轮的优先级列表中。如果≤30%的参与者回答≥7，则排除陈述。在第二轮中，与会者表示了他们对没有达成初步共识的声明的一致意见，加上基于第一轮参与者反馈的修改声明。如果≥50％的参与者在李克特量表上回答≥7，则将第2轮陈述纳入第3轮。在第3轮中，参与者优先考虑体征和症状。
结果：44名参与者（93.6％）完成了所有3轮比赛。41种体征和症状中的4种在第1轮之后达成共识，9种在第2轮之后达成共识。第3轮中最优先考虑的10种体征和症状是最近的跌倒，白天嗜睡或嗜睡，异常运动(例如，晃动或刚度)，困惑或迷失方向，平衡问题,头晕,体位性低血压,减少自我照顾，躁动,口干。
结论：前10种体征和症状为主动监测精神型ADE提供了依据。
