Development of a Symptom-Focused Model to Guide the Prescribing of Antipsychotics in Children and Adolescents: Results of the First Phase of the Safer Use of Antipsychotics in Youth (SUAY) Clinical Trial.
Development of a Symptom-Focused Model to Guide the Prescribing of Antipsychotics in Children and Adolescents: Results of the First Phase of the Safer Use of Antipsychotics in Youth (SUAY) Clinical Trial.
复制标题
DOI：
10.1016/j.jaac.2021.04.010
复制
发表时间：
2022-01
影响因子：
13.3
通讯作者：
Simon GE
中科院分区：
文献类型：
--
作者：
Penfold RB;Thompson EE;Hilt RJ;Schwartz N;Robb AS;Correll CU;Newton D;Rogalski K;Earls MF;Kowatch RA;Beck A;Yarborough BJH;Crystal S;Vitiello B;Kelleher KJ;Simon GE
开发一种新的处方指南方法，作为务实试验“青少年有针对性且更安全地使用抗精神病药物”（SUAY - ClinicalTrials.gov 标识符：NCT03448575）的一部分，支持处方医生向青少年提供高质量的心理健康护理。使用名义组技术来确定针对目标症状和潜在诊断的一线治疗。该小组包括美国儿科医生、儿童和青少年精神病学家以及精神药理学专家。会议材料包括有关医疗补助审查计划、系统审查、处方指南和实用试验描述的信息。随后，举行了一系列四次网络研讨会讨论，就建议达成共识。专家组一致认为，指南应重点关注目标症状而不是诊断。指南包括针对目标心理健康症状的一线至一线治疗的建议、要解决的环境因素、应首先考虑和排除的可能的潜在诊断，以及药物和治疗的一般考虑因素。处方指南经常被忽视，因为它们没有考虑现实世界中一线心理社会治疗的可用性、共病情况和临床复杂性。我们的方法解决了其中一些问题。如果该方法在我们正在进行的实用试验“青少年有针对性和更安全地使用抗精神病药物”(SUAY) 中被证明是成功的，那么它可以作为国家医疗补助计划和卫生系统的模型，以支持临床医生为青少年提供高质量的心理健康护理。
To develop a new approach to prescribing guidelines as part of a pragmatic trial, Targeted and Safer Use of Antipsychotics in Youth (SUAY - ClinicalTrials.gov Identifier: NCT03448575) that supports prescribers in delivering high-quality mental health care to youth. A nominal group technique was used to identify first to nth line treatments for target symptoms and potential diagnoses. The panel included US pediatricians, child and adolescent psychiatrists and psychopharmacology experts. Meeting materials included information about Medicaid review programs, systematic reviews, prescribing guidelines, and a description of the pragmatic trial. Afterwards, a series of four webinar discussions were held to achieve consensus on recommendations. The panel unanimously agreed that the guideline should focus on target symptoms rather than diagnoses. Guidance included recommendations for 1st- to nth-line treatment of target mental health symptoms, environmental factors to be addressed, possible underlying diagnoses that should first be considered and ruled out, and general considerations for pharmacological and therapeutic treatments. Prescribing guidelines are often ignored because they do not incorporate the real-world availability of first-line psychosocial treatments, comorbid conditions and clinical complexity. Our approach addresses some of these concerns. If the approach proves successful in our ongoing pragmatic trial, Targeted and Safer Use of Antipsychotics in Youth (SUAY), it may serve as a model to state Medicaid programs and health systems to support clinicians in delivering high-quality mental health care to youth.
登录
查看更多内容
影响因子：
3.4
作者：
Barclay, Rebecca P.;Penfold, Robert B.;Hilt, Robert J.
通讯作者：
Hilt, Robert J.
影响因子：
2.1
作者：
Chiara, Ashley N.;Kashalikar, Neha;Jeffrey, Paul L.
通讯作者：
Jeffrey, Paul L.
影响因子：
1.8
作者：
Eapen, Valsamma;John, George
通讯作者：
John, George
DOI：
10.1016/b978-0-12-416048-4.00002-6
发表时间：
2013-01-01
期刊：
TELEMENTAL HEALTH: CLINICAL,TECHNICAL,AND ADMINISTRATIVE FOUNDATIONS FOR EVIDENCE-BASED PRACTICE
影响因子：
--
作者：
Flaum, Michael
通讯作者：
Flaum, Michael
DOI：
10.1016/j.jaac.2017.10.006
发表时间：
2017-12-01
影响因子：
13.3
作者：
DelBello, Melissa P.;Goldman, Robert;Loebel, Antony
通讯作者：
Loebel, Antony