title: Knowledge and Attitude Towards Pharmacological Management of Acute Agitation: A Survey of Psychiatrists, Psychiatry Residents, and Psychiatric Nurses.
abstract: OBJECTIVE
  The authors compared the current knowledge and attitude of psychiatrists, psychiatry residents, and psychiatric nurses towards the pharmacological management of acute agitation.
  
  
  METHODS
  Questionnaires were electronically distributed to all attending psychiatrists, psychiatry residents, and psychiatric nurses who were either employed by the University Department of Psychiatry and Behavioral Sciences or were staff at a 250-bed affiliated Psychiatric Hospital. Where possible, Fisher's exact test was used to compare responses to questions based on designation.
  
  
  RESULTS
  Of the 250 questionnaires distributed, 112 were returned (response rate of 44.8%), of which 64 (57.1%) were psychiatric nurses, 27 (24.1%) were attending psychiatrists, and 21 (18.8%) were psychiatry residents. A significantly higher percentage of attending psychiatrists and psychiatric nurses compared to psychiatry residents thought that newer second- generation antipsychotics (SGAs) are not as effective as older first-generation antipsychotics (FGAs) for managing acute agitation (55.6, 48.4, and 9.5% respectively, p = 0.008). The combination of intramuscular haloperidol, lorazepam, and diphenhydramine was the most preferred option chosen by all designations for the psychopharmacological management of severe agitation. Furthermore, a larger percentage of the psychiatric nurses, in comparison to attending psychiatrists, also chose the combination of intramuscular chlorpromazine, lorazepam, and diphenhydramine as an option for managing severe agitation; no psychiatry resident chose this option.
  
  
  CONCLUSIONS
  Knowledge of evidence-based psychopharmacological management of agitation differs among attending psychiatrists, psychiatry residents and psychiatric nurses. Although the management of agitation should be individualized and context specific, monotherapy should be considered first where applicable.
authors.affiliation: University of Texas Harris County Psychiatric Center, Houston, TX, USA.
authors.forename: KeumbÔh
authors.initials: K
authors.lastname: Tangu
authors.affiliation: University of Texas Harris County Psychiatric Center, Houston, TX, USA.
authors.forename: Adaora
authors.initials: A
authors.lastname: Ifeanyi
authors.affiliation: University of Texas Harris County Psychiatric Center, Houston, TX, USA.
authors.forename: Mayurapriya
authors.initials: M
authors.lastname: Velusamy
authors.affiliation: University of Texas Harris County Psychiatric Center, Houston, TX, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Dar
authors.affiliation: The Harris Center for Mental Health and IDD, Houston, TX, USA.
authors.forename: Nurun
authors.initials: N
authors.lastname: Shah
authors.affiliation: University of Texas Harris County Psychiatric Center, Houston, TX, USA.
authors.forename: Ifeoma E
authors.initials: IE
authors.lastname: Ezeobele
authors.affiliation: University of Texas Harris County Psychiatric Center, Houston, TX, USA. Olaoluwa.O.Okusaga@uth.tmc.edu.|University of Texas Health Science Center at Houston, Houston, TX, USA. Olaoluwa.O.Okusaga@uth.tmc.edu.
authors.forename: Olaoluwa O
authors.initials: OO
authors.lastname: Okusaga
mesh_terms: D000328:Adult; D058633:Antipyretics / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency; D008297:Male; D009726:Nurses / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*; D011568:Psychiatric Nursing; D011570:Psychiatry / Q000193:education / Q000706:statistics & numerical data*; D011595:Psychomotor Agitation / Q000188:drug therapy*
chemical_list: D058633:Antipyretics
keywords: Agitation; Antipsychotics; Project BETA; Psychiatric nurses; Psychiatric residents; Psychiatrists