Evidence map›Paper›PMID 28124100›Full record

ReviewZeitschrift fur Gerontologie und Geriatrie2017

[Treatment with psychotropic agents in patients with dementia and delirium : Gap between guideline recommendations and treatment practice].

Walter Hewer, Christine Thomas

Abstract readReview
PubMed Publisher
In one paragraph

Review in Zeitschrift fur Gerontologie und Geriatrie, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.0field-weighted citation impact, top 15% 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

3 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
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

2 authors at 2 institutions in 1 country.

Walter HewerKlinik für Gerontopsychiatrie, Klinikum Christophsbad, Faurndauerstr. 6-28, 73035, Göppingen, Deutschland. walter.hewer@christophsbad.de.ORCID http://orcid.org/0000-0002-5874-2408
Christine ThomasKlinik für Psychiatrie und Psychotherapie für Ältere, Klinikum Stuttgart, Stuttgart, Deutschland.
Christophorus Kliniken · DEKlinikum Stuttgart · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesPsychiatric symptoms in dementia and delirium are associated with a substantially reduced quality of life of patients and their families and often challenging for professionals. Pharmacoepidemiological surveys have shown that, in particular, patients living in nursing homes receive prescriptions of psychotropic agents in significant higher frequency than recommended by current guidelines. This article focuses on a critical appraisal of this gap from the point of view of German healthcare services. MATERIAL AND

methodsNarrative review with special reference to the German dementia guideline from 2016 and recently published practice guidelines for delirium in old age in German and English language.

resultsThe indications for use of psychotropic agents, especially antipsychotics, are defined narrowly in the German dementia guideline. According to this guideline for several psychopathological symptoms evidence based recommendations cannot be given, currently. For delirium several practice guidelines related to different treatment settings have been published recently. Comparable to the German dementia guideline they recommend general medical interventions and nonpharmacological treatment as first line measures and the use of psychotropic agents only under certain conditions. These guidelines differ to some extent regarding the strength of recommendation for psychopharmacological treatment.

conclusionThe guidelines discussed here advocate well-founded a cautious prescription of psychotropic agents in patients with dementia and delirium. This contrasts to everyday practice which is characterized by significantly higher prescription rates. This gap may explained partially by a lack of evidence-based recommendations regarding certain psychopathological symptoms. Most notably, however, epidemiological data disclose an unacceptable rate of hazardous overtreatment with psychotropic agents, especially in long-term care of persons with dementia. In this situation counteractive measures by consequent implementation of the principles of good clinical practice in geriatrics are required urgently.

Indexed as

Practice Guidelines as TopicAgedAged, 80 and overDeliriumDementiaDose-Response Relationship, DrugDrug Administration ScheduleDrug MonitoringEvidence-Based MedicineFemaleGeriatric AssessmentGeriatricsGermanyGuideline AdherenceHumansMalePsychotropic DrugsAdministration and dosageDrug monitoringEvidence-based medicineNonpharmacological treatment

Identifiers

PMID28124100
OpenAlexW2582187967

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.