Objective: Evidence base for rapid tranquillisation is an under researched area. Guidelines on rapid tranquilisation from English speaking countries were appraised using AGREE (Appraisal of Guidelines Research and Eva...Objective: Evidence base for rapid tranquillisation is an under researched area. Guidelines on rapid tranquilisation from English speaking countries were appraised using AGREE (Appraisal of Guidelines Research and Evaluation) and differences in their recommendations were analysed. Methods: Four independent psychiatrists appraised the guidelines using the AGREE tool. AGREE is a validated instrument used to assess the quality of guideline and recommendations using six domains of which each domain captures a specific aspect of the guideline development. The content was analysed manually. Results: Seven guidelines from five English speaking countries met the inclusion criteria. All the guidelines scored well on the domain of “scope and purpose”. NICE guidelines from the UK consistently scored well on all domains with the maximum possible score of 100 on the “applicability” domain. APA from the USA did well on the domain of “editorial independence”. AGREE could only examine the guideline development process and not the content. The guidelines differed in their recommendations of choice of drug for rapid tranquillisation. Discussion: All guidelines scored reasonably well on AGREE. National Institute of Clinical Excellence (NICE) has used robust strategies in developing the guidelines. Guidelines failed to achieve consensus in recommendations despite using a common pool of evidence. Haloperidol-promethazine combination is not recommended by any with the exception of NICE. This suggests data is selectively interpreted depending on locally prevalent customs.展开更多
Patients with serious mental illness have an increased prevalence of the metabolic syndrome in comparison to the general population. Metabolic syndrome is a constellation of cardiovascular risk factors including diabe...Patients with serious mental illness have an increased prevalence of the metabolic syndrome in comparison to the general population. Metabolic syndrome is a constellation of cardiovascular risk factors including diabetes, hypertension, obesity and dyslipidemia. It is potentially reversible and may explain the higher incidence of cardiovascular disease in patients with serious mental illness. The aim of the study is to see the prevalence of metabolic syndrome among mentally ill patients and what might be the underlying the cause behind the scene A descriptive, retrospective study was conducted at mental health clinic, Batticaloa, Teaching Hospital (BTH), Sri Lanka. The data were collected over a period of two months from 15th of October to 15th of December 2017. Data were harvested from the medical records. Total 55 mentally ill patient’s medical records were analyzed for this study. Out of 55, females were 30 (54.5%) and males were 25 (45.5%). Furthermore, 30 (54.5%) patients had an evidence of metabolic syndrome. The association of metabolic syndrome among male and female was not statistically significant (P > 0.05). In this study, metabolic syndrome is more prevalent among, patient with trifluoperazine (70%) drug group, risperidone (66.6%) and olanzapine (53.12%).展开更多
文摘Objective: Evidence base for rapid tranquillisation is an under researched area. Guidelines on rapid tranquilisation from English speaking countries were appraised using AGREE (Appraisal of Guidelines Research and Evaluation) and differences in their recommendations were analysed. Methods: Four independent psychiatrists appraised the guidelines using the AGREE tool. AGREE is a validated instrument used to assess the quality of guideline and recommendations using six domains of which each domain captures a specific aspect of the guideline development. The content was analysed manually. Results: Seven guidelines from five English speaking countries met the inclusion criteria. All the guidelines scored well on the domain of “scope and purpose”. NICE guidelines from the UK consistently scored well on all domains with the maximum possible score of 100 on the “applicability” domain. APA from the USA did well on the domain of “editorial independence”. AGREE could only examine the guideline development process and not the content. The guidelines differed in their recommendations of choice of drug for rapid tranquillisation. Discussion: All guidelines scored reasonably well on AGREE. National Institute of Clinical Excellence (NICE) has used robust strategies in developing the guidelines. Guidelines failed to achieve consensus in recommendations despite using a common pool of evidence. Haloperidol-promethazine combination is not recommended by any with the exception of NICE. This suggests data is selectively interpreted depending on locally prevalent customs.
文摘Patients with serious mental illness have an increased prevalence of the metabolic syndrome in comparison to the general population. Metabolic syndrome is a constellation of cardiovascular risk factors including diabetes, hypertension, obesity and dyslipidemia. It is potentially reversible and may explain the higher incidence of cardiovascular disease in patients with serious mental illness. The aim of the study is to see the prevalence of metabolic syndrome among mentally ill patients and what might be the underlying the cause behind the scene A descriptive, retrospective study was conducted at mental health clinic, Batticaloa, Teaching Hospital (BTH), Sri Lanka. The data were collected over a period of two months from 15th of October to 15th of December 2017. Data were harvested from the medical records. Total 55 mentally ill patient’s medical records were analyzed for this study. Out of 55, females were 30 (54.5%) and males were 25 (45.5%). Furthermore, 30 (54.5%) patients had an evidence of metabolic syndrome. The association of metabolic syndrome among male and female was not statistically significant (P > 0.05). In this study, metabolic syndrome is more prevalent among, patient with trifluoperazine (70%) drug group, risperidone (66.6%) and olanzapine (53.12%).
