TY - JOUR
T1 - Systematic Review of Psychotropic Adverse Drug Event Monitoring Tools for Use in Long-Term Care Facilities
AU - McInerney, Brigid E.
AU - Cross, Amanda J.
AU - Turner, Justin P.
AU - Bell, J. Simon
N1 - Funding Information:
BEM is supported by a postgraduate research scholarship funded by Monash University . AJC is supported by a National Health and Medical Research Council (NHMRC) Emerging Leadership 1 grant ( APP2009633 ). JSB is supported by an NHMRC Boosting Dementia Research Leadership Fellowship .
Funding Information:
BEM is supported by a postgraduate research scholarship funded by Monash University. AJC is supported by a National Health and Medical Research Council (NHMRC) Emerging Leadership 1 grant (APP2009633). JSB is supported by an NHMRC Boosting Dementia Research Leadership Fellowship.AJC has received grant funding from the Medical Research Future Fund (GA187306). JSB has received grant funding or consulting funds from the NHMRC, Medical Research Future Fund, Victorian Government Department of Health and Human Services, Dementia Australia Research Foundation, Yulgilbar Foundation, Aged Care Quality and Safety Commission, Dementia Centre for Research Collaboration, Pharmaceutical Society of Australia, Society of Hospital Pharmacists of Australia, GlaxoSmithKline Supported Studies Programme, Amgen, and several aged care provider organizations unrelated to this work. All grants and consulting funds were paid to the employing institution. BEM and JPT have no real or perceived conflicts of interest to declare.
Funding Information:
AJC has received grant funding from the Medical Research Future Fund ( GA187306 ). JSB has received grant funding or consulting funds from the NHMRC , Medical Research Future Fund , Victorian Government Department of Health and Human Services , Dementia Australia Research Foundation , Yulgilbar Foundation , Aged Care Quality and Safety Commission , Dementia Centre for Research Collaboration , Pharmaceutical Society of Australia , Society of Hospital Pharmacists of Australia , GlaxoSmithKline Supported Studies Programme, Amgen , and several aged care provider organizations unrelated to this work. All grants and consulting funds were paid to the employing institution. BEM and JPT have no real or perceived conflicts of interest to declare.
Publisher Copyright:
© 2023 AMDA – The Society for Post-Acute and Long-Term Care Medicine
PY - 2023/6
Y1 - 2023/6
N2 - Objectives: To evaluate properties of psychotropic adverse drug event (ADE) monitoring tools intended for use in long-term care facilities. Design: Systematic review. Setting and Participants: Adults aged 18 years and older in nursing homes and other long-term care facilities. Methods: Medline, CINAHL, Embase, and PsycInfo were searched from inception to August 2022 for studies reporting the development, validation, or application of tools to monitor psychotropic ADEs. Screening, data extraction, and quality assessment were performed independently by 2 authors. Each tool was assessed under the domains of test-retest reliability, interrater reliability, content validity, and construct validity. Results: Eight studies that described 6 tools were included. Tools were developed in Wales (n = 2), United States (n = 1), Ireland (n = 1), Canada (n = 1), and Singapore (n = 1). Tools monitored 4 to 95 items related to antipsychotics (n = 6 tools), antidepressants (n = 4), benzodiazepines or hypnotics (n = 4), antiepileptics (n = 4), and dementia medications (n = 1). Tools commonly monitored sedation, tiredness, or sleepiness (n = 6), falls (n = 4), and tremor or extrapyramidal symptoms (n = 4). Tools were designed for application by nurses (n = 4), during family conferences (n = 1), and by general medical practitioners before repeat prescribing (n = 1). Two tools were reported to require 10 to 60 minutes to administer. Four tools were determined to have adequate content validity and 2 tools adequate interrater reliability. No tools reported test-retest reliability or construct validity. Conclusions and Implications: Six published psychotropic ADE monitoring tools are heterogeneous in design and intended application. Existing tools are predominately designed for application by nurses with or without direct involvement of the wider multidisciplinary team. Further research is needed into models of care that facilitate psychotropic ADE monitoring in the long-term care facility setting, and the extent to which application of specific tools is associated with reduced medication-related harm.
AB - Objectives: To evaluate properties of psychotropic adverse drug event (ADE) monitoring tools intended for use in long-term care facilities. Design: Systematic review. Setting and Participants: Adults aged 18 years and older in nursing homes and other long-term care facilities. Methods: Medline, CINAHL, Embase, and PsycInfo were searched from inception to August 2022 for studies reporting the development, validation, or application of tools to monitor psychotropic ADEs. Screening, data extraction, and quality assessment were performed independently by 2 authors. Each tool was assessed under the domains of test-retest reliability, interrater reliability, content validity, and construct validity. Results: Eight studies that described 6 tools were included. Tools were developed in Wales (n = 2), United States (n = 1), Ireland (n = 1), Canada (n = 1), and Singapore (n = 1). Tools monitored 4 to 95 items related to antipsychotics (n = 6 tools), antidepressants (n = 4), benzodiazepines or hypnotics (n = 4), antiepileptics (n = 4), and dementia medications (n = 1). Tools commonly monitored sedation, tiredness, or sleepiness (n = 6), falls (n = 4), and tremor or extrapyramidal symptoms (n = 4). Tools were designed for application by nurses (n = 4), during family conferences (n = 1), and by general medical practitioners before repeat prescribing (n = 1). Two tools were reported to require 10 to 60 minutes to administer. Four tools were determined to have adequate content validity and 2 tools adequate interrater reliability. No tools reported test-retest reliability or construct validity. Conclusions and Implications: Six published psychotropic ADE monitoring tools are heterogeneous in design and intended application. Existing tools are predominately designed for application by nurses with or without direct involvement of the wider multidisciplinary team. Further research is needed into models of care that facilitate psychotropic ADE monitoring in the long-term care facility setting, and the extent to which application of specific tools is associated with reduced medication-related harm.
KW - adverse event monitoring
KW - Drug-related side effects and adverse reactions
KW - long-term care
KW - nursing homes
KW - psychotropic drugs
KW - residential facilities
UR - http://www.scopus.com/inward/record.url?scp=85153534585&partnerID=8YFLogxK
U2 - 10.1016/j.jamda.2023.03.003
DO - 10.1016/j.jamda.2023.03.003
M3 - Review Article
C2 - 37037347
AN - SCOPUS:85153534585
SN - 1525-8610
VL - 24
SP - P773-781.E5
JO - JAMDA
JF - JAMDA
IS - 6
ER -
