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智力残疾成年人精神药物的管理:一项范围综述方案

Management of psychotropic medications in adults with intellectual disability: a scoping review protocol.

作者信息

Costello Ashley, Hehir Cian, Sharma Drona, Hudson Eithne, Doody Owen, Kelly Dervla

机构信息

School of Medicine, University of Limerick, Castletroy, Limerick, Ireland.

Nua Healthcare Services, Republic of Ireland, Ireland.

出版信息

HRB Open Res. 2022 Jan 12;4:30. doi: 10.12688/hrbopenres.13170.2. eCollection 2021.

Abstract

Psychotropic medications are commonly prescribed among adults with intellectual disability (ID), often in the absence of a psychiatric diagnosis. As such, there is great disparity between the estimated prevalence of mental illness and the rates of psychotropic medication use amongst people with ID. 'Off-label' use of these medications may account for much of this discrepancy, in particular their use in the management of challenging behaviour. This has come under scrutiny due to the myriad of side effects and the deficiency of high-quality data supporting their use for this indication. Understanding the causes and justifications for such disparity is essential in discerning the efficacy of current prescription practice. : To explore the existing evidence base regarding the prescription and management of psychotropic medications in adults with ID. The aim will be achieved through identifying the psychotropic medications commonly prescribed, the underlying rationale(s) for their prescription and the evidence available that demonstrates their appropriateness and effectiveness. Additionally, the paper will seek to evaluate the availability of any existing guidance that informs the management of these medications, and the evidence and outcomes of psychotropic medication dose reduction and/or cessation interventions.  This review will consider studies that focus on the use of psychotropic medications amongst patients with ID. Research studies (qualitative, quantitative and mixed design) and Grey Literature (English) will be included. The search will be conducted without time restrictions. Databases will include: Ovid MEDLINE, Embase, CINAHL, JBI Evidence Synthesis, Cochrane Central Register of Controlled Trials, Cochrane Databased of Systematic Reviews, PsycINFO and Scopus. A three-step search strategy will be followed, with results screened by two independent reviewers. Data will be extracted independently by two reviewers using a data extraction tool with results mapped and presented using a narrative form supported by tables and diagrams.

摘要

精神药物在成年智力残疾者中普遍被处方使用,且常常是在没有精神疾病诊断的情况下。因此,在智力残疾者中,精神疾病的估计患病率与精神药物的使用比率之间存在巨大差异。这些药物的“非标签”使用可能是造成这种差异的主要原因,尤其是在用于管理具有挑战性的行为方面。由于其众多的副作用以及缺乏支持其用于该适应症的高质量数据,这一情况受到了审查。了解这种差异的原因和理由对于辨别当前处方实践的疗效至关重要。:探讨关于成年智力残疾者精神药物处方和管理的现有证据基础。该目标将通过确定常用的精神药物、其处方的潜在理由以及表明其适用性和有效性的现有证据来实现。此外,本文将寻求评估为这些药物管理提供指导的任何现有指南的可用性,以及精神药物剂量减少和/或停药干预的证据和结果。本综述将考虑关注智力残疾患者精神药物使用的研究。将纳入研究性研究(定性、定量和混合设计)以及灰色文献(英文)。搜索将不受时间限制进行。数据库将包括:Ovid MEDLINE、Embase、CINAHL、JBI证据综合数据库、Cochrane对照试验中心注册库、Cochrane系统评价数据库、PsycINFO和Scopus。将遵循三步搜索策略,结果由两名独立评审员筛选。数据将由两名评审员使用数据提取工具独立提取,结果通过表格和图表支持的叙述形式进行映射和呈现。

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