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.
accessibility
antipsychotic
consulting
guidelines
Journal
Journal of the American Academy of Child and Adolescent Psychiatry
ISSN: 1527-5418
Titre abrégé: J Am Acad Child Adolesc Psychiatry
Pays: United States
ID NLM: 8704565
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
received:
15
05
2020
revised:
24
03
2021
accepted:
01
04
2021
pubmed:
15
7
2021
medline:
28
1
2022
entrez:
14
7
2021
Statut:
ppublish
Résumé
To develop a new approach to prescribing guidelines as part of a pragmatic trial, Safer Use of Antipsychotics in Youth (SUAY; ClinicalTrials.gov Identifier: NCT03448575), which supports prescribers in delivering high-quality mental health care to youths. 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. Afterward, a series of 4 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 first- 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, 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 youths. Safer Use of Antipsychotics in Youth; http://clinicaltrials.gov/; NCT03448575.
Identifiants
pubmed: 34256967
pii: S0890-8567(21)00276-8
doi: 10.1016/j.jaac.2021.04.010
pmc: PMC8566327
mid: NIHMS1698629
pii:
doi:
Substances chimiques
Antipsychotic Agents
0
Banques de données
ClinicalTrials.gov
['NCT03448575']
Types de publication
Clinical Trial
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
93-102Subventions
Organisme : NIMH NIH HHS
ID : HHSN271201600002C
Pays : United States
Organisme : AHRQ HHS
ID : R01 HS026001
Pays : United States
Organisme : AHRQ HHS
ID : R18 HS023258
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR003017
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2021 American Academy of Child & Adolescent Psychiatry. All rights reserved.
Références
J Am Acad Child Adolesc Psychiatry. 2009 Sep;48(9):961-973
pubmed: 19692857
Curr Psychiatry Rep. 2013 Dec;15(12):426
pubmed: 24258527
JAMA Pediatr. 2013 Feb;167(2):141-8
pubmed: 23403911
Australas Psychiatry. 2011 Jun;19(3):232-5
pubmed: 21682621
J Am Acad Child Adolesc Psychiatry. 2006 Jun;45(6):642-657
pubmed: 16721314
Prim Care Companion CNS Disord. 2012;14(1):
pubmed: 22690363
J Am Acad Child Adolesc Psychiatry. 2017 Jan;56(1):59-66
pubmed: 27993230
JAMA Psychiatry. 2019 Mar 1;76(3):259-270
pubmed: 30649197
Am J Psychiatry. 2013 Sep;170(9):1051-8
pubmed: 23896958
Ment Health Clin. 2020 Nov 5;10(6):354-357
pubmed: 33224693
Pediatrics. 2012 Jun;129(6):e1577-86
pubmed: 22641763
Arch Dis Child Educ Pract Ed. 2011 Oct;96(5):192-6
pubmed: 21771730
Clin Psychol Rev. 2011 Apr;31(3):465-71
pubmed: 21130552
J Child Adolesc Psychopharmacol. 2011 Dec;21(6):505-15
pubmed: 22196314
J Child Adolesc Psychopharmacol. 2018 Apr;28(3):158-165
pubmed: 29376743
Pediatrics. 2011 Dec;128(6):1135-41
pubmed: 22106077
Health Aff (Millwood). 2016 Jun 1;35(6):974-82
pubmed: 27269012
Nat Rev Endocrinol. 2011 Oct 18;8(2):114-26
pubmed: 22009159
World Psychiatry. 2020 Feb;19(1):69-80
pubmed: 31922663
J Am Acad Child Adolesc Psychiatry. 2013 Apr;52(4):378-88
pubmed: 23582869
Arch Pediatr Adolesc Med. 2003 Jan;157(1):17-25
pubmed: 12517190
Pediatrics. 2012 Mar;129(3):e771-84
pubmed: 22351885
Fam Pract. 2012 Oct;29(5):567-75
pubmed: 22308179
JAMA. 2009 Oct 28;302(16):1765-73
pubmed: 19861668
Community Ment Health J. 2013 Feb;49(1):33-44
pubmed: 22383046
J Clin Psychopharmacol. 2021 Jan/Feb 01;41(1):13-18
pubmed: 33347017
Contemp Clin Trials. 2020 Dec;99:106184
pubmed: 33091587
J Am Acad Child Adolesc Psychiatry. 2002 May;41(5):514-21
pubmed: 12014783
J Am Acad Child Adolesc Psychiatry. 2010 Jan;49(1):13-23
pubmed: 20215922
J Child Adolesc Psychopharmacol. 2011 Dec;21(6):517-35
pubmed: 22166172
Perspect Psychol Sci. 2011 Jan;6(1):21-37
pubmed: 26162113
Psychiatr Serv. 2019 Oct 1;70(10):944-947
pubmed: 31310188
Health Aff (Millwood). 2009 Sep-Oct;28(5):w770-81
pubmed: 19622537
Am Psychol. 2011 Dec;66(9):825-34
pubmed: 22121982
J Am Acad Child Adolesc Psychiatry. 2017 Dec;56(12):1015-1025
pubmed: 29173735
Pediatrics. 2008 Jan;121(1):e157-63
pubmed: 18166534
Implement Sci. 2014 Dec 31;9:780
pubmed: 25551791
JAMA. 2000 Feb 23;283(8):1025-30
pubmed: 10697062
JAMA Psychiatry. 2015 Sep;72(9):859-60
pubmed: 26132589
Implement Sci. 2012 Jul 04;7:61
pubmed: 22762158
J Am Acad Child Adolesc Psychiatry. 2007 Jan;46(1):126-141
pubmed: 17195736
BMJ. 2011 Oct 18;343:d5928
pubmed: 22008217
Paediatr Child Health. 2011 Nov;16(9):581-9
pubmed: 23115502
Psychiatr Danub. 2010 Jun;22(2):298-300
pubmed: 20562768
Pediatrics. 2012 Jun;129(6):e1562-76
pubmed: 22641762
Implement Sci. 2012 Jul 04;7:62
pubmed: 22762242
Medicine (Baltimore). 2016 Jun;95(23):e3784
pubmed: 27281081
J Am Acad Child Adolesc Psychiatry. 2003 Feb;42(2):145-61
pubmed: 12544174
CNS Drugs. 2012 Sep 1;26(9):733-59
pubmed: 22900950
JAMA Pediatr. 2013 Feb;167(2):162-8
pubmed: 23247331
J Am Acad Child Adolesc Psychiatry. 2014 Dec;53(12):1298-1307.e2
pubmed: 25457928
Health Technol Assess. 2004 Feb;8(6):iii-iv, 1-72
pubmed: 14960256
Pediatrics. 2010 Mar;125(3):475-82
pubmed: 20142282
Health Serv Res. 2017 Apr;52(2):561-578
pubmed: 28297075
Psychiatr Serv. 2017 Oct 1;68(10):1061-1067
pubmed: 28566023
J Am Acad Child Adolesc Psychiatry. 2006 Sep;45(9):1023-1031
pubmed: 16840879
Lancet. 2019 Sep 14;394(10202):939-951
pubmed: 31303314
Arch Gen Psychiatry. 2012 Dec;69(12):1247-56
pubmed: 22868273
J Clin Psychiatry. 2017 Sep/Oct;78(8):e957-e969
pubmed: 28493653
Cochrane Database Syst Rev. 2012 Sep 12;(9):CD008559
pubmed: 22972123
J Child Adolesc Psychopharmacol. 2017 Aug;27(6):516-525
pubmed: 28475373
Int J Med Inform. 2010 Jun;79(6):430-7
pubmed: 20378396
JAMA Psychiatry. 2016 Mar;73(3):247-59
pubmed: 26792761
Implement Sci. 2012 Jul 04;7:60
pubmed: 22762776
J Manag Care Spec Pharm. 2018 Aug;24(8):746-751
pubmed: 30058981
Am J Psychiatry. 2002 Apr;159(4):561-6
pubmed: 11925293
BMJ. 1999 Feb 20;318(7182):527-30
pubmed: 10024268
J Contin Educ Health Prof. 2004 Fall;24 Suppl 1:S31-7
pubmed: 15712775