title: A consensus guideline for antipsychotic drug use for dementia in care homes. Bridging the gap between scientific evidence and clinical practice.
abstract: BACKGROUND
  To produce a practice guideline that includes a set of detailed consensus principles regarding the prescription of antipsychotics (APs) amongst people with dementia living in care homes.
  
  
  METHODS
  We used a modified Delphi consensus procedure with three rounds, where we actively specified and optimized statements throughout the process, utilizing input from four focus groups, carried out in UK, Norway, and the Netherlands. This was done to identify relevant themes and a set of statement that experts agreed upon using the Research and Development/University of California at Los Angeles (RAND/UCLA) methodology.
  
  
  RESULTS
  A total of 72 scientific and clinical experts and 14 consumer experts reached consensus upon 150 statements covering five themes: (1) General prescription stipulations, (2) assessments prior to prescription, (3) care and treatment plan, (4) discontinuation, and (5) long-term treatment.
  
  
  CONCLUSIONS
  In this practice guideline, novel information was provided about detailed indication and thresholds of symptoms, risk factors, circumstances at which APs should be stopped or tapered, specific criteria for justifying long-term treatment, involvement of the multidisciplinary team, and family caregiver in the process of prescription. The practice guideline is based on formal consensus of clinicians and consumer experts and provides clinicians relevant practical information that is lacking in current guidelines.
authors.affiliation: Department of General Practice,University Medical Center Groningen,University of Groningen,Groningen,the Netherlands.
authors.forename: Sytse U
authors.initials: SU
authors.lastname: Zuidema
authors.affiliation: Department of Primary and Community Care,Centre for Family Medicine,Geriatric Care and Public Health,Radboud University Medical Centre,Nijmegen,the Netherlands.
authors.forename: Alice
authors.initials: A
authors.lastname: Johansson
authors.affiliation: Norwegian National Advisory Unit of Ageing and Health,Vestfold Hospital Trust,Tønsberg,Norway;Centre for Old Age Psychiatry Research,Innlandet Hospital Trust,Ottestad,Norway;Institute of Clinical Medicine,Campus AHUS,University of Oslo,Norway.
authors.forename: Geir
authors.initials: G
authors.lastname: Selbaek
authors.affiliation: UK Alzheimer's Society,London,UK.
authors.forename: Matt
authors.initials: M
authors.lastname: Murray
authors.affiliation: Faculty of Medical and Human Sciences,Institute of Brain,Behaviour and Mental Health,The University of Manchester,UK.
authors.forename: Alistair
authors.initials: A
authors.lastname: Burns
authors.affiliation: Wolfson Centre for Age-Related Diseases,Kings College London,UK.
authors.forename: Clive
authors.initials: C
authors.lastname: Ballard
authors.affiliation: Department of Primary and Community Care,Centre for Family Medicine,Geriatric Care and Public Health,Radboud University Medical Centre,Nijmegen,the NetherlandsandJoachim & Anna,center for specialized geriatric care,Nijmegen,the Netherlands.
authors.forename: Raymond T C M
authors.initials: RT
authors.lastname: Koopmans
mesh_terms: D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D032921:Consensus; D003697:Delphi Technique; D003704:Dementia / Q000175:diagnosis / Q000188:drug therapy*; D006707:Homes for the Aged / Q000592:standards; D006801:Humans; D009735:Nursing Homes / Q000592:standards; D017410:Practice Guidelines as Topic
chemical_list: D014150:Antipsychotic Agents
keywords: dementia; nursing homes; psychopharmacology