Sensibilisation au bon usage des antipsychotiques pour soulager les symptômes comportementaux et psychologiques de la démence chez la personne âgée en centre de soins de longue durée (SENS-AP)
Bibliographic record
Abstract
Resume Objectif : Cette etude a evalue l’impact d’une intervention multimodale sur le taux de conformite a des criteres de bon usage des ordonnances d’antipsychotiques pour des patients atteints de symptomes comportementaux et psychologiques de la demence en centre de soins de longue duree. Methodologie : Cette etude a compare le taux d’ordonnances conformes selon trois criteres (dose adequate en geriatrie, molecule recommandee et validite de l’indication) cinq et une semaine avant l’intervention, puis un et trois mois apres celle-ci. L’intervention comprenait la distribution d’un algorithme encadrant la prescription d’antipsychotiques, des notes redigees par des residents en pharmacie dans les dossiers medicaux non conformes et des rencontres avec l’equipe traitante. L’analyse du taux de conformite des dossiers a ete effectuee avec un modele d’equations d’estimations generalisees. Resultats : Des 188 utilisateurs d’antipsychotiques identifies dans trois centres de soins de longue duree de Laval, 126 ont ete inclus dans l’analyse primaire. Le suivi de ces utilisateurs a permis de decrire la conformite de leur ordonnance aux criteres de bon usage. Le taux de conformite est passe de 74,6 % au temps 0 a 81,5 % au temps 1 (p = 0,240) puis a 89,5 % au temps 2 (p < 0,001 pour la difference entre les temps 0 et 2 et p = 0,031 pour la difference entre les temps 1 et 2). Conclusion : Une intervention multimodale peut ameliorer la qualite de l’usage des antipsychotiques pour soulager les patients des symptomes comportementaux et psychologiques de la demence en centre de soins de longue duree. Abstract Objective : This study evaluated the impact of a multimodal intervention on the compliance rate with certain criteria on the appropriate use of antipsychotic medication orders for patients with behavioural and psychological symptoms of dementia in long-term care centres. Methodology : This study compared the rate of compliant medication orders according to three criteria (proper geriatric dose, recommended drug and valid indication) 5 weeks and 1 week before and 1 month and 3 months after the intervention. The intervention involved distributing an algorithm for guiding antipsychotic prescribing, pharmacy residents writing notes for noncompliant patient charts and meetings with the healthcare team. The analysis of the medical record compliance rate was performed using a generalized estimate equation model. Results : Of the 188 antipsychotic users identified at three long-term care centres in Laval, 126 were included in the primary analysis. Tracking these users enabled us to describe the compliance of their medication orders with the appropriate use criteria. The compliance rate increased from 74.6% at time 0 to 81.5% at time 1 (p = 0.240) and then to 89.5% at time 2 (p < 0.001 for the difference between times 0 and 2 and p = 0.031 for that between times 1 and 2). Conclusion : A multimodal intervention can improve the quality of the use of antipsychotics to relieve the behavioural and psychological symptoms of dementia in patients in long-term care centres.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.027 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".