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Lookup NU author(s): Professor Adam ToddORCiD
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© 2024 AMDA – The Society for Post-Acute and Long-Term Care MedicineObjectives: To produce a consensus list of the top 10 signs and symptoms suggestive of adverse drug events (ADEs) for monitoring in residents of long-term care facilities (LTCFs) who use antipsychotics, benzodiazepines, or antidepressants. Design: A 3-round Delphi study. Setting and Participants: Geriatricians, psychiatrists, pharmacologists, general practitioners, pharmacists, nurses, and caregivers from 13 Asia Pacific, European, and North American countries. Methods: Three survey rounds were completed between April and June 2023. In Round 1, participants indicated their level of agreement on a 9-point Likert scale on whether 41 signs or symptoms identified in a systematic review should be routinely monitored. Participants considered signs and symptoms that reduce quality of life or cause significant harm, are observable or measurable by nurses or care workers, and can be assessed at a single time point. Round 1 statements were included in a list for prioritization in Round 3 if ≥ 70% of participants responded ≥7 on the Likert scale. Statements were excluded if ≤ 30% of participants responded ≥7. In Round 2, participants indicated their level of agreement with statements that did not reach initial consensus, plus amended statements based on Round 1 participant feedback. Round 2 statements were included in Round 3 if ≥ 50% of the participants responded ≥7 on the Likert scale. In Round 3, participants prioritized the signs and symptoms. Results: Forty-four participants (93.6%) completed all 3 rounds. Four of 41 signs and symptoms reached consensus for inclusion after Round 1, and 9 after Round 2. The top 10 signs and symptoms prioritized in Round 3 were recent falls, daytime drowsiness or sleepiness, abnormal movements (eg, shaking or stiffness), confusion or disorientation, balance problems, dizziness, postural hypotension, reduced self-care, restlessness, and dry mouth. Conclusions and Implications: The top 10 signs and symptoms provide a basis for proactive monitoring for psychotropic ADEs.
Author(s): McInerney BE, Cross AJ, Alderman CP, Bhat R, Boyd CM, Brandt N, Cossette B, Desforges K, Dowd LA, Frank C, Hartikainen S, Herrmann N, Hilmer SN, Jack L, Jordan S, Kitamura CR, Koujiya E, Lampela P, Macfarlane S, Manias E, Martin C, Martinez-Velilla N, Moriarty F, Onder G, Quirke T, Silvius JL, Soulsby N, Stafford AC, Steinman MA, Sun W, Taguchi R, Todd A, Trenaman SC, Yap KZ, Zhao M, Bell JS, Turner JP
Publication type: Article
Publication status: Published
Journal: Journal of the American Medical Directors Association
Year: 2024
Volume: 25
Issue: 9
Print publication date: 01/09/2024
Online publication date: 29/06/2024
Acceptance date: 02/04/2018
ISSN (print): 1525-8610
ISSN (electronic): 1538-9375
Publisher: Elsevier Inc.
URL: https://doi.org/10.1016/j.jamda.2024.105118
DOI: 10.1016/j.jamda.2024.105118
PubMed id: 38950588
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