Evidence map›Paper›PMID 28062471›Full record

SynthesisBMJ open2017

Pharmacological guidelines for schizophrenia: a systematic review and comparison of recommendations for the first episode.

Dolores Keating, Stephen McWilliams, Ian Schneider, Caroline Hynes, Gráinne Cousins, Judith Strawbridge, Mary Clarke

Abstract readComparative StudySystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
56citing papers in PubMed, 4 pooled it
–field-weighted citation impact
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

56 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Guideline
  2. Pooled it
  3. Pooled it
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  5. Trial
  6. Review
  7. Review
  8. Article
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  14. Article
  15. Optical coherence tomography reveals retinal thinning in schizophrenia spectrum disorders.European archives of psychiatry and clinical neuroscience · 2023
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  17. Article
  18. Review
  19. Observational
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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

7 authors.

Dolores KeatingPharmacy Department, Saint John of God Hospital, Co Dublin, Ireland.
Stephen McWilliamsSaint John of God Hospital, Co Dublin, Ireland.
Ian SchneiderDepartment of Old Age Psychiatry, Saint James's Hospital, Dublin, Ireland.
Caroline HynesPharmacy Department, Saint John of God Hospital, Co Dublin, Ireland.
Gráinne CousinsSchool of Pharmacy, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
Judith StrawbridgeSchool of Pharmacy, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
Mary ClarkeDETECT Early Intervention in Psychosis Service, Blackrock, Co Dublin, Ireland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesClinical practice guidelines (CPGs) support the translation of research evidence into clinical practice. Key health questions in CPGs ensure that recommendations will be applicable to the clinical context in which the guideline is used. The objectives of this study were to identify CPGs for the pharmacological treatment of first-episode schizophrenia; assess the quality of these guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument; and compare recommendations in relation to the key health questions that are relevant to the pharmacological treatment of first-episode schizophrenia.

methodsA multidisciplinary group identified key health questions that are relevant to the pharmacological treatment of first-episode schizophrenia. The MEDLINE and EMBASE databases, websites of professional organisations and international guideline repositories, were searched for CPGs that met the inclusion criteria. The AGREE II instrument was applied by three raters and data were extracted from the guidelines in relation to the key health questions.

resultsIn total, 3299 records were screened. 10 guidelines met the inclusion criteria. 3 guidelines scored well across all domains. Recommendations varied in specificity. Side effect concerns, rather than comparative efficacy benefits, were a key consideration in antipsychotic choice. Antipsychotic medication is recommended for maintenance of remission following a first episode of schizophrenia but there is a paucity of evidence to guide duration of treatment. Clozapine is universally regarded as the medication of choice for treatment resistance. There is less evidence to guide care for those who do not respond to clozapine.

conclusionsAn individual's experience of using antipsychotic medication for the initial treatment of first-episode schizophrenia may have implications for future engagement, adherence and outcome. While guidelines of good quality exist to assist in medicines optimisation, the evidence base required to answer key health questions relevant to the pharmacological treatment of first-episode schizophrenia is limited.

Indexed as

Administration, OralAdolescentAdultAgedAntipsychotic AgentsDrug ResistanceHumansMiddle AgedPractice Guidelines as TopicSchizophreniaYoung AdultAntipsychotic Agentsantipsychoticpsychosis

Identifiers

PMID28062471
PMCPMC5223704

What OpenQuestion holds

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Registered trials

None linked

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.