Background: Agitation is a common challenging behaviour in dementia with a negative influence on patient's quality of life and a high caregiver burden. Treatment is often difficult. Current guidelines recommend restrictive use of psychotropic drug treatment, but guideline recommendations do not always suffice.
Objective: To explore how physicians decide on psychotropic drug treatment for agitated behaviour in dementia when the guideline prescribing recommendations are not sufficient.
Methods: We conducted five online focus groups with a total of 22 elderly care physicians, five geriatricians and four old-age psychiatrists, in The Netherlands. The focus groups were thematically analysed.
Results: We identified five main themes. Transcending these themes, in each of the focus groups physicians stated that there is 'not one size that fits all'. The five themes reflect physicians' considerations when deciding on psychotropic drug treatment outside the guideline prescribing recommendations for agitated behaviour in dementia: (1) 'reanalysis of problem and cause', (2) 'hypothesis of underlying cause and treatment goal', (3) 'considerations regarding drug choice', (4) 'trial and error' and (5) 'last resort: sedation'.
Conclusion: When guideline prescribing recommendations do not suffice, physicians start with reanalysing potential underlying causes. They try to substantiate and justify medication choices as best as they can with a hypothesis of underlying causes or treatment goal, using other guidelines, and applying personalised psychotropic drug treatment.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9441198 | PMC |
| http://dx.doi.org/10.1093/ageing/afac189 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Objective: Aim: To investigate the etiology, pathogenesis, and effectiveness of pharmacotherapy and psychotherapeutic modalities of delusions in Schizophrenia spectrum and other Psychotic Disorders.
Patients And Methods: Materials and Methods: In our study, we included English-language studies from online databases such as Web of Science, Scopus, Google Scholar, PubMed, and the Cochrane Library conducted until January 2024 using the following keywords "delusions", "Schizophrenia spectrum and other Psychotic Disorders", "pharmacotherapy", "psychotherapy", and "antipsychotics". Scientific novelty: There is already published evidence that has studied Schizophrenia spectrum disorders from definition to treatment.
Ingredient-based method to create medication lists and support granular data segmentation.
Health Informatics J
January 2025
College of Health Solutions, Arizona State University, Phoenix, AZ, USA.
Show the generalizability of an ingredient-based method to automatically create an up-to-date, error-free, complete list of medication codes (e.g., opioid medications with at least one opioid ingredient) from an ingredient list (e.
View Article and Find Full Text PDFInsights into prescribing patterns for antidepressants: an evidence-based analysis.
BMC Med Inform Decis Mak
January 2025
Department of Health Administration and Policy, College of Public Health, George Mason University, 4400 University Dr, Fairfax, VA, 22030, USA.
Background: Antidepressants are a primary treatment for depression, yet prescribing them poses significant challenges due to the absence of clear guidelines for selecting the most suitable option for individual patients. This study aimed to analyze prescribing patterns for antidepressants across healthcare providers, including physicians, physician assistants, nurse practitioners, and pharmacists, to better understand the complex factors influencing these patterns in the management of depression.
Methods: Least Absolute Shrinkage and Selection Operator (LASSO) regression was employed to identify variables that explained the variation in the prescribed antidepressants, utilizing a large number of claims.
Electrophysiological characterization of human KCNT1 channel modulators and the therapeutic potential of hydroquinine and tipepidine in KCNT1 mutation-associated epilepsy mouse model.
Acta Pharmacol Sin
January 2025
Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221004, China.
Patients suffering epilepsy caused by the gain-of-function mutants of the hKCNT1 potassium channels are drug refractory. In this study, we cloned a novel human KCNT1B channel isoform using the brain cDNA library and conducted patch-clamp and molecular docking analyses to characterize the pharmacological properties of the hKCNT1B channel using thirteen drugs. Among cinchona alkaloids, we found that hydroquinine exerted the strongest blocking effect on the hKCNT1B channel, especially the F313L mutant.
View Article and Find Full Text PDFEsketamine at a Clinical Dose Attenuates Cerebral Ischemia/Reperfusion Injury by Inhibiting AKT Signaling Pathway to Facilitate Microglia M2 Polarization and Autophagy.
Drug Des Devel Ther
January 2025
Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China.
Purpose: This study aimed to assess the protective effect of a clinical dose esketamine on cerebral ischemia/reperfusion (I/R) injury and to reveal the potential mechanisms associated with microglial polarization and autophagy.
Methods: Experimental cerebral ischemia was induced by middle cerebral artery occlusion (MCAO) in adult rats and simulated by oxygen-glucose deprivation (OGD) in BV-2 microglial cells. Neurological and sensorimotor function, cerebral infarct volume, histopathological changes, mitochondrial morphological changes, and apoptosis of ischemic brain tissues were assessed in the presence or absence of esketamine and the autophagy inducer rapamycin.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!