Evidence map›Paper›PMID 25642751›Full record

ArticleInternational psychogeriatrics2015

The development and testing of the quality use of medications in dementia (QUM-D): a tool for quality prescribing for behavioral and psychological symptoms of dementia (BPSD).

Carmelle Peisah, Julie-Anne Strukovski, Chanaka Wijeratne, Rosalind Mulholland, Georgina Luscombe, Henry Brodaty

Open access · diamondAbstract read
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In one paragraph

Article in International psychogeriatrics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–field-weighted citation impact, top 92% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Carmelle PeisahSpecialist Mental Health Services for Older People,Mental Health Drug and Alcohol,Northern Sydney Local Health District,Sydney,Australia.
Julie-Anne StrukovskiSpecialist Mental Health Services for Older People,Mental Health Drug and Alcohol,Northern Sydney Local Health District,Sydney,Australia.
Chanaka WijeratneUniversity of NSW,Sydney,Australia.
Rosalind MulhollandSpecialist Mental Health Services for Older People,Mental Health Drug and Alcohol,Northern Sydney Local Health District,Sydney,Australia.
Georgina LuscombeUniversity of Sydney,Sydney,Australia.
Henry BrodatyDementia Collaborative Research Centre,University of New South Wales,Sydney,Australia.
University of Sydney · AUNorthern Sydney Local Health District · AUDementia Collaborative Research Centres · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBehavioral and psychological symptoms of dementia (BPSD) are virtually ubiquitous in dementia. Excessive recourse to use of psychotropics which have high risk to benefit ratio remains a global problem. We aimed to identify components of quality prescribing in BPSD to develop a tool for quality prescribing and to test this tool.

methodsWe used Delphi methodology to identify elements of quality prescribing in BPSD. The tool was tested by a range of medical and nursing professionals on 48 patients, in inpatient and ambulatory settings in Northern Sydney Local Health District, Australia.

resultsConsensual opinion using Delphi method was that quality prescribing in dementia comprised ten factors including failure to use first line non-pharmacological strategies, indication, choice of drug, consent, dosage, mode of administration, titration, polypharmacy, toxicity, and review. These elements formed the quality use of medications in dementia (QUM-D) tool, lower scores of which reflected quality prescribing, with a possible range of scores from 0 to 30. When inter-rater reliability was tested on a subgroup of raters, QUM-D showed high inter-rater reliability. A significant reduction in QUM-D scores was demonstrated from baseline to follow-up, mean difference being 5.3 (SD = 3.8; 95% confidence interval 4.1-6.4; t = 9.5; df = 47; p < 0.001). There was also a significant reduction in score from baseline to follow-up when rated by clinical nurse consultants from a specialized behavior assessment management service (BAMS) (N = 12).

conclusionThe QUM-D is a tool which may help to improve quality prescribing practices in the context of BPSD. In this setting, we consider quality prescribing, and accordingly the obligations of prescribers, to be an inclusive concept rather than just adding to the mantra of "not prescribing."

Indexed as

Decision Support TechniquesDelphi TechniqueDementiaDrug PrescriptionsHumansNootropic AgentsObserver VariationQuality of Health CareTreatment OutcomeNootropic AgentsBPSDdementiamedicationsprescribingquality

Identifiers

PMID25642751
PMCPMC4501300
OpenAlexW2042727234

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.