减少神经发育障碍患者精神药物不当处方和管理的干预措施：系统回顾和荟萃分析

IF 2.1 3区医学 Q2 PSYCHOLOGY, EDUCATIONAL

Journal of Applied Research in Intellectual Disabilities Pub Date : 2025-04-01 DOI:10.1111/jar.70046

Ben Younan, Mikaela Jorgensen, Glenys Holt, Monica Cuskelly, Manya Angley, Robyn Wallace, Juanita Breen, Donna Gillies

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引用次数: 0

摘要

背景：神经发育障碍患者经常被开具或服用精神药物，特别是为了控制令人担忧的行为。几十年来，减少精神药物的不当使用一直是国际研究和政策的目标。方法检索6个电子数据库，以减少该人群中精神药物的不当处方或使用。结果本综述纳入了16项前后研究。荟萃分析显示，在药物评价、多成分干预、工作场所培训和组织指导方针和政策方面接受精神药物治疗的参与者人数显著减少（风险比[RR] = 0.52, 95% CI [0.43, 0.62], p < 0.00）。亚组分析显示，所有干预措施均有显著减少，不同干预类型间减少量无明显差异。结论：干预减少了精神药物的使用。然而，潜在的偏倚和高异质性表明，需要随机对照试验（rct）来得出更明确的结论。

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Interventions to Reduce Inappropriate Prescribing and Administration of Psychotropic Medications for People With Neurodevelopmental Disabilities: A Systematic Review and Meta-Analysis

Background

People with neurodevelopmental disabilities are frequently prescribed or administered psychotropic medication, particularly to manage behaviours of concern. Reducing inappropriate psychotropic use has been the target of international research and policy for several decades.

Methods

Six electronic databases were searched for interventions to reduce inappropriate prescribing or administration of psychotropics in this population.

Results

Sixteen pre–post studies were included in this review. Meta-analysis showed a significant reduction in the number of participants receiving psychotropics for medication review, multi-component interventions, workplace training, and organisational guidelines and policies (risk ratio [RR] = 0.52, 95% CI [0.43, 0.62], p < 0.00). Subgroup analysis showed significant reductions with all interventions, with no apparent differences in reduction size between intervention types.

Conclusion

Interventions reduced psychotropic use in a meta-analysis of pre–post studies. However, potential bias and high heterogeneity suggest that randomised controlled trials (RCTs) are needed for more definitive conclusions.

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来源期刊

Journal of Applied Research in Intellectual Disabilities Multiple-

CiteScore

4.70

自引率

12.50%

发文量

期刊介绍： JARID is an international, peer-reviewed journal which draws together findings derived from original applied research in intellectual disabilities. The journal is an important forum for the dissemination of ideas to promote valued lifestyles for people with intellectual disabilities. It reports on research from the UK and overseas by authors from all relevant professional disciplines. It is aimed at an international, multi-disciplinary readership. Topics covered include community living, quality of life, challenging behaviour, communication, sexuality, medication, ageing, supported employment, family issues, mental health, physical health, autism, economic issues, social networks, staff stress, staff training, epidemiology and service provision.