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Agitated Behavior Scale

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1. Management of aggression, agitation and behavioural disturbances in dementia: carbamazepine

the 6-week study. There was no statistically significant difference between the carbamazepine and placebo groups in Clinical Global Impression of Change or global Brief Psychiatric Rating Scale scores (BPRS: a measure of behaviour). The hostility item on the BPRS scale was statistically significantly improved with carbamazepine compared with placebo (difference 1.55 points on a 7-point scale, p=0.009). Management of aggression, agitation and behavioural disturbances in dementia: carbamazepine (...) . Although some outcomes measured using rating scales were found to be statistically significant in some studies, the effect sizes appear small and it is unclear whether they are clinically important. Management of aggression, agitation and behavioural disturbances in dementia: carbamazepine (ESUOM40) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 5 of 21The average age of people included in the 4 RCTs was 79 years

2015 National Institute for Health and Clinical Excellence - Advice

2. A systematic review of the clinical effectiveness and cost-effectiveness of sensory, psychological and behavioural interventions for managing agitation in older adults with dementia

. Advantages were not demonstrated with ‘therapeutic touch’ or individualised activity. Aromatherapy and light therapy did not show clinical effectiveness. Training family carers in behavioural or cognitive interventions did not decrease severe agitation. The few studies reporting activities of daily living or quality-of-life outcomes found no improvement, even when agitation had improved. We identi?ed two health economic studies. Costs of interventions which signi?cantly impacted on agitation were (...) aggression. 13 The term ‘agitation’ may also include wandering. 14 The impact of agitation can be devastating for people with dementia, as well as for their family and for paid carers. The socioeconomic impact is also huge. For the person with dementia, it has been associated with poor quality of life. 13,15 This may result directly from the agitated feelings and resultant behaviour, which often occurs several times per hour, occupying a considerable proportion of their day. 16 Agitation also affects

2014 NIHR HTA programme

3. Agitated Behavior Scale

Agitated Behavior Scale Agitated Behavior Scale Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Agitated Behavior Scale Agitated (...) Behavior Scale Aka: Agitated Behavior Scale II. Protocol: Scoring Score 1: Absent Score 2: Slight Does not prevent patient from conducting other appropriate behavior Score 3: Moderate Requires redirection from agitated to appropriate behavior Score 4: Extreme Despite redirection attempts, persists III. Protocol: Behaviors (assign a score of 1 to 4 to each of the following 14) Short attention span, easy distractibility, inability to concentrate Impulsive, impatient, low tolerance for pain or frustration

2018 FP Notebook

4. Do care homes deliver person-centred care? A cross-sectional survey of staff-reported abusive and positive behaviours towards residents from the MARQUE (Managing Agitation and Raising Quality of Life) English national care home survey. Full Text available with Trip Pro

Do care homes deliver person-centred care? A cross-sectional survey of staff-reported abusive and positive behaviours towards residents from the MARQUE (Managing Agitation and Raising Quality of Life) English national care home survey. There are widespread concerns about abuse of care home residents. We report, in the largest care home survey, prevalence of staff anonymously-reported, perpetrated/witnessed abusive behaviours towards care home residents over 3 months. We also report positive (...) care behaviours.1544 staff in 92 English care home units completed the revised Modified Conflict Tactics Scale and Maslach Burnout Inventory.Most staff reported positive care behaviours, but specific person-centred activities were sometimes infrequent. Many care home staff were never or almost never aware of a resident being taken out of the home for their enjoyment (34%, n = 520); or an activity planned around a resident's interests (15%, n = 234). 763 (51%; 95% Confidence Interval (CI) 47% to 54

2018 PLoS ONE

5. Pharmacological interventions for agitated behaviours in patients with traumatic brain injury: a systematic review. Full Text available with Trip Pro

was not the presenting symptom, but was measured as an outcome variable; and (3) safety of pharmacological interventions administered to control agitated behaviours was measured.Among the 181 articles assessed for eligibility, 21 studies were included. Of the studies suggesting possible benefits, propranolol reduced maximum intensities of agitation per week and physical restraint use, methylphenidate improved anger measures following 6 weeks of treatment, valproic acid reduced weekly agitated behaviour scale ratings (...) Pharmacological interventions for agitated behaviours in patients with traumatic brain injury: a systematic review. The aim of this systematic review was to assess the efficacy and safety of pharmacological agents in the management of agitated behaviours following traumatic brain injury (TBI).We performed a search strategy in PubMed, OvidMEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library, Google Scholar, Directory of Open Access Journals, LILACS, Web of Science and Prospero (up to 10 December

2019 BMJ open

6. Non-pharmacological interventions for agitation/aggressive behaviour in patients with dementia: a randomized controlled crossover trial. (Abstract)

conducted in Greece. The following measures were used: the Mini-Mental State Examination, Addenbrooke's Cognitive Examination Revised, Geriatric Depression Scale, Functional Rating Scale for Symptoms in Dementia and Neuropsychiatric Inventory. According to the results the most effective nonpharmacological intervention for reducing agitation/aggressive behaviour in PwD was music therapy, followed by aromatherapy and massage, and finally physical exercise. (...) Non-pharmacological interventions for agitation/aggressive behaviour in patients with dementia: a randomized controlled crossover trial. Agitation/aggressive behaviour is a common behavioural and psychological symptom in people with dementia (PwD), occurring with a frequency of between 13-50.4% according to recent studies, and the rate increases as the severity of cognitive decline increases. The burden on caregivers is considerable. This trial is a randomized controlled crossover trial

2019 Functional Neurology Controlled trial quality: uncertain

7. Development and Validation of a Risk Scale for Emergence Agitation After General Anesthesia in Children: A Prospective Observational Study. (Abstract)

Development and Validation of a Risk Scale for Emergence Agitation After General Anesthesia in Children: A Prospective Observational Study. Emergence agitation (EA) is a common complication in children after general anesthesia. The goal of this 2-phase study was (1) to develop a predictive model (EA risk scale) for the incidence of EA in children receiving sevoflurane anesthesia by performing a retrospective analysis of data from our previous study (phase 1) and (2) to determine the validity (...) of the EA risk scale in a prospective observational cohort study (phase 2).Using data collected from 120 patients in our previous study, logistic regression analysis was used to predict the incidence of EA in phase 1. The optimal combination of the predictors was determined by a stepwise selection procedure using Akaike information criterion. The β-coefficient for the selected predictors was calculated, and scores for predictors determined. The predictive ability of the EA risk scale was assessed

2017 Anesthesia and Analgesia

8. Clozapine for persistent aggressive behaviour or agitation in people with schizophrenia [Cochrane protocol]

Clozapine for persistent aggressive behaviour or agitation in people with schizophrenia [Cochrane protocol] Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files (...) of reperfusion (if applicable). ">Data to be extracted: animal model Example: Dose, timing of administration, frequency of administration, route of administration, vehicle. ">Data to be extracted: intervention of interest Example: Serum creatinine; continuous; umol/L (may be recalculated from mg/dL). ">Data to be extracted: primary outcome(s) Example: Blood urea nitrogen; continuous; mmol/L (may be recalculated from mg/dL); Renal histological damage as assessed by Jablonski scale; continuous; Jablonski score

2020 PROSPERO

9. Clinical practice guidelines for pain, agitation, delirium, sedation and mobilisation in the intensive care unit: A Rapid Review

pain than men after cardiac surgery. Moderate iii. Procedural pain is common in adult ICU patients. Moderate Pain assessment i. We recommend that pain be routinely monitored in all adult ICU patients. Moderate ii. The Behavioral Pain Scale (BPS) and the Critical-Care Pain Observation Tool (CPOT) are the most valid and reliable behavioral pain scales for monitoring pain in medical, postoperative, or trauma (except for brain injury) adult ICU patients who are unable to self-report and in whom motor (...) function is intact and behaviors are observable. Using these scales in other ICU patient populations and translating them into foreign languages other than French or English require further validation testing. Moderate iii. We do not suggest that vital signs (or observational pain scales that include vital signs) be used alone for pain assessment in adult ICU patients. Low iv. We suggest that vital signs may be used as a cue to begin further assessment of pain in these patients, however. Low Treatment

2019 Monash Health Evidence Reviews

10. Agitated Behavior and Activities of Daily Living Retraining During Posttraumatic Amnesia. (Abstract)

, admitted to rehabilitation, in PTA of more than 7 days.ADL retraining during PTA followed errorless and procedural learning principles.Group comparison and regression modeling of patient agitation data from a randomized controlled trial comparing ADL retraining in PTA (treatment) versus no ADL retraining in PTA (treatment as usual, TAU).Agitation using the Agitated Behavior Scale. Therapy participation measured in minutes and missed sessions.There were no group differences in agitated behavior (average (...) Agitated Behavior and Activities of Daily Living Retraining During Posttraumatic Amnesia. Patients in posttraumatic amnesia (PTA) may receive limited rehabilitation due to the risk of overstimulation and agitation. This assumption has not been tested.To examine the relationship between agitated behavior and participation in therapy for retraining of activities of daily living (ADL) while in PTA.Inpatient rehabilitation center.A total of 104 participants with severe traumatic brain injury

2019 The Journal of head trauma rehabilitation Controlled trial quality: uncertain

11. Valproate preparations for agitation in dementia. Full Text available with Trip Pro

participants. Studies varied in the preparations of valproate, mean doses (480 mg/day to 1000 mg/day), duration of treatment (three weeks to six weeks), and outcome measures used. The studies were generally well conducted although some methodological information was missing and one study was at high risk of attrition bias.The quality of evidence related to our primary efficacy outcome of agitation varied from moderate to very low. We found moderate-quality evidence from two studies that measured behaviour (...) with the total Brief Psychiatric Rating Scale (BPRS) score (range 0 to 108) and with the BPRS agitation factor (range 0 to 18). They found that there was probably little or no effect of valproate treatment over six weeks (total BPRS: mean difference (MD) 0.23, 95% confidence interval (CI) -2.14 to 2.59; 202 participants, 2 studies; BPRS agitation factor: MD -0.67, 95% CI -1.49 to 0.15; 202 participants, 2 studies). Very low-quality evidence from three studies which measured agitation with the Cohen-Mansfield

2018 Cochrane

12. Risperidone for psychosis-induced aggression or agitation (rapid tranquillisation). Full Text available with Trip Pro

for tranquillisation or any economic outcomes. Data were available for our other main outcomes of agitation or aggression, needing restraint, and incidence of adverse effects.Risperidone versus haloperidol (up to 24 hours follow-up)For the outcome, specific behaviour - agitation, no clear difference was found between risperidone and haloperidol in terms of efficacy, measured as at least 50% reduction in the Positive and Negative Syndrome Scale - Psychotic Agitation Sub-score (PANSS-PAS) (RR 1.04, 95% CI 0.86 (...) was observed for agitation measured as PANSS-PAS endpoint score at two hours (MD 2.50, 95% CI -2.46 to 7.46; very low-quality evidence); need to use restraints at four days (RR 1.43, 95% CI 0.39 to 5.28; very-low quality evidence); specific movement disorders measured as Behavioural Activity Rating Scale (BARS) endpoint score at four days (MD 0.20, 95% CI -0.43 to 0.83; very low-quality evidence).Risperidone versus quetiapineOne trial reported (n = 40) useable data for the comparison risperidone versus

2018 Cochrane

13. Agitation and Aggression in Long-Term Care Residents with Dementia

? Population: Old people with dementia o 2/3 or separate analyses ? Intervention: Everything other than specific drugs o But, does include the modification or review of drug regimens ? Comparator: Usual care ? Outcome: Agitation and aggression o Look for: behavioural and psychological symptoms of dementia (BPSD), psychological problems, behavioural problems, executive function, frontal lobe function o Doesn’t cut it: cognitive function, ADL/IADL, quality of life, anything to do with caregivers, anything (...) depression symptoms) and did not result in any adverse events. The other high quality review (4) looked specifically at short-term exercise interventions (defined as up to three months in duration). Fleiner et al. concluded from five primary research studies that exercise improves behavioral and psychological symptoms of dementia (BPSD) generally, but without finding evidence for improved aggression/agitation specifically. The authors suggest that the mechanism is not that exercise reduces agitation per

2018 Newfoundland and Labrador Centre for Health Information

14. Effect of Dexmedetomidine on Emergence Agitation and Postoperative Behavior Changes in Children

Effect of Dexmedetomidine on Emergence Agitation and Postoperative Behavior Changes in Children Effect of Dexmedetomidine on Emergence Agitation and Postoperative Behavior Changes in Children - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one (...) or more studies before adding more. Effect of Dexmedetomidine on Emergence Agitation and Postoperative Behavior Changes in Children The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03596775 Recruitment Status : Not yet

2018 Clinical Trials

15. The Behavioral and Psychological Symptoms of Dementia in Down Syndrome (BPSD-DS) Scale: Comprehensive Assessment of Psychopathology in Down Syndrome Full Text available with Trip Pro

The Behavioral and Psychological Symptoms of Dementia in Down Syndrome (BPSD-DS) Scale: Comprehensive Assessment of Psychopathology in Down Syndrome People with Down syndrome (DS) are prone to develop Alzheimer's disease (AD). Behavioral and psychological symptoms of dementia (BPSD) are core features, but have not been comprehensively evaluated in DS. In a European multidisciplinary study, the novel Behavioral and Psychological Symptoms of Dementia in Down Syndrome (BPSD-DS) scale was developed (...) to identify frequency and severity of behavioral changes taking account of life-long characteristic behavior. 83 behavioral items in 12 clinically defined sections were evaluated. The central aim was to identify items that change in relation to the dementia status, and thus may differentiate between diagnostic groups. Structured interviews were conducted with informants of persons with DS without dementia (DS, n = 149), with questionable dementia (DS+Q, n = 65), and with diagnosed dementia (DS+AD, n = 67

2018 Journal of Alzheimer's Disease

16. Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU Full Text available with Trip Pro

(such as those with neuromuscular diseases); research on the application of the BPAT in ICU practice is encouraged. However, situations exist for which behavioral scales are impossible to use (e.g., unresponsive patients with a Richmond Agitation- Sedation Scale [RASS] ≤ −4). In such situations, no alternative methods are currently available to ICU clinicians. Other technology that may be useful in the ICU pain assessment process should be explored. Technology measuring HR variability (e.g., the Analgesia (...) ” the experiencing person says it is, existing “whenever” the experiencing person says it does ( ). Although the reference standard measure of pain is a patient’s self-report, the inability to communicate clearly does not negate a patient’s pain experience or the need for appropriate pain management ( ). Fortunately, validated behavioral pain scales provide alternative measures for pain assessment in those patients unable to self-report their pain . Severe pain negatively affects patient status (e.g., cardiac

2018 Society of Critical Care Medicine

17. Agitation in Dementia: Quantifying the effects of antipsychotics

February 26, 2018 Agitation in Dementia: Quantifying the effects of antipsychotics Clinical Question: What are the benefits and harms of antipsychotics for agitation in dementia? Bottom Line: A strong placebo effect explains most of the perceived efficacy, with antipsychotics providing little additional improvement over placebo on agitation scales (~3 additional points out of 144). However, 50% improvement in behaviour occurs in ~46% on antipsychotic versus ~33% on placebo. Harms are serious (increased (...) Agitation in Dementia: Quantifying the effects of antipsychotics Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,800 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care research. www.acfp.ca

2018 Tools for Practice

18. Challenging behaviour and learning disabilities: prevention and interventions for people with learning disabilities whose behaviour challenges

ensure that all interventions for behaviour that challenges are delivered by competent staff. Staff should: receive regular high-quality supervision that takes into account the impact of individual, social and environmental factors deliver interventions based on the relevant treatment manuals consider using routine outcome measures at each contact (for example, the Adaptive Behavior Scale and the Aberrant Behavior Checklist) take part in monitoring (for example, by using Periodic Service Review (...) , significant staff changes or moving to a new care setting). 1.4.2 Consider using direct observation and recording or formal rating scales (for example, the Adaptive Behavior Scale or Aberrant Behavior Checklist) to monitor the development of behaviour that challenges. 1.5 Assessment of behaviour that challenges The assessment process The assessment process 1.5.1 When assessing behaviour that challenges shown by children, young people and adults with a learning disability follow a phased approach, aiming

2015 National Institute for Health and Clinical Excellence - Clinical Guidelines

19. Droperidol for psychosis-induced aggression or agitation. Full Text available with Trip Pro

Droperidol for psychosis-induced aggression or agitation. People experiencing acute psychotic illnesses, especially those associated with agitated or violent behaviour, may require urgent pharmacological tranquillisation or sedation. Droperidol, a butyrophenone antipsychotic, has been used for this purpose in several countries.To estimate the effects of droperidol, including its cost-effectiveness, when compared to placebo, other 'standard' or 'non-standard' treatments, or other forms (...) of management of psychotic illness, in controlling acutely disturbed behaviour and reducing psychotic symptoms in people with schizophrenia-like illnesses.We updated previous searches by searching the Cochrane Schizophrenia Group Register (18 December 2015). We searched references of all identified studies for further trial citations and contacted authors of trials. We supplemented these electronic searches by handsearching reference lists and contacting both the pharmaceutical industry and relevant

2016 Cochrane

20. Withdrawal versus continuation of long-term antipsychotic drug use for behavioural and psychological symptoms in older people with dementia. Full Text available with Trip Pro

to whether or not participants complete the study (low-quality evidence).Two trials included only participants with psychosis, agitation or aggression who had responded to antipsychotic treatment. In these two trials, stopping antipsychotics was associated with a higher risk of leaving the study early due to symptomatic relapse or a shorter time to symptomatic relapse.We found low-quality evidence that discontinuation may make little or no difference to overall NPS, measured using various scales (7 (...) or no important effect on behavioural and psychological symptoms. This is consistent with the observation that most behavioural complications of dementia are intermittent and often do not persist for longer than three months. Discontinuation may have little or no effect on overall cognitive function. Discontinuation may make no difference to adverse events and quality of life. Based on the trials in this review, we are uncertain whether discontinuation of antipsychotics leads to a decrease in mortality.People

2018 Cochrane

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