Cargando…
Pharmacological interventions for agitation in patients with traumatic brain injury: protocol for a systematic review and meta-analysis
BACKGROUND: Traumatic brain injury (TBI) is a worldwide leading cause of mortality and disability. Among TBI complications, agitation is a frequent behavioural problem. Agitation causes potential harm to patients and caregivers, interferes with treatments, leads to unnecessary chemical and physical...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5114826/ https://www.ncbi.nlm.nih.gov/pubmed/27855720 http://dx.doi.org/10.1186/s13643-016-0374-6 |
_version_ | 1782468415375540224 |
---|---|
author | Williamson, David R. Frenette, Anne Julie Burry, Lisa Perreault, Marc M. Charbonney, Emmanuel Lamontagne, François Potvin, Marie-Julie Giguère, Jean-François Mehta, Sangeeta Bernard, Francis |
author_facet | Williamson, David R. Frenette, Anne Julie Burry, Lisa Perreault, Marc M. Charbonney, Emmanuel Lamontagne, François Potvin, Marie-Julie Giguère, Jean-François Mehta, Sangeeta Bernard, Francis |
author_sort | Williamson, David R. |
collection | PubMed |
description | BACKGROUND: Traumatic brain injury (TBI) is a worldwide leading cause of mortality and disability. Among TBI complications, agitation is a frequent behavioural problem. Agitation causes potential harm to patients and caregivers, interferes with treatments, leads to unnecessary chemical and physical restraints, increases hospital length of stay, delays rehabilitation, and impedes functional independence. Pharmacological treatments are often considered for agitation management following TBI. Several types of agents have been proposed for the treatment of agitation. However, the benefit and safety of these agents in TBI patients as well as their differential effects and interactions are uncertain. In addition, animal studies and observational studies have suggested impaired cognitive function with the use of certain antipsychotics and benzodiazepines. Hence, a safe and effective treatment for agitation, which does not interfere with neurological recovery, remains to be identified. METHODS/DESIGN: With the help of Health Sciences librarian, we will design a search strategy in the following databases: PubMed, Ovid MEDLINE®, EMBASE, CINAHL, PsycINFO, Cochrane Library, Google Scholar, Directory of Open Access Journals, LILACS, Web of Science, and Prospero. A grey literature search will be performed using the resources suggested in CADTH’s Grey Matters. We will include all randomized controlled, quasi-experimental, and observational studies with control groups. The population of interest is all patients, including children and adults, who have suffered a TBI. We will include studies in which agitation, not further defined, was the presenting symptom or one of the presenting symptoms. We will also include studies where agitation was not the presenting symptom but was measured as an outcome variable and studies assessing the safety of these pharmacological interventions in TBI patients. We will include studies evaluating all pharmacological interventions including beta-adrenergic blockers, typical and atypical antipsychotics, anticonvulsants, dopamine agonists, psychostimulants, antidepressants, alpha-2-adrenergic agonists, hypnotics, and anxiolytics. DISCUSSION: Although agitation is frequent following TBI and pharmacological agents that are often used, there is no consensus on the most efficacious and safest strategy to treat these complications. There is a need for an updated systematic review to summarize the evidence in order to inform practice and future research. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016033140 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13643-016-0374-6) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5114826 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-51148262016-11-25 Pharmacological interventions for agitation in patients with traumatic brain injury: protocol for a systematic review and meta-analysis Williamson, David R. Frenette, Anne Julie Burry, Lisa Perreault, Marc M. Charbonney, Emmanuel Lamontagne, François Potvin, Marie-Julie Giguère, Jean-François Mehta, Sangeeta Bernard, Francis Syst Rev Protocol BACKGROUND: Traumatic brain injury (TBI) is a worldwide leading cause of mortality and disability. Among TBI complications, agitation is a frequent behavioural problem. Agitation causes potential harm to patients and caregivers, interferes with treatments, leads to unnecessary chemical and physical restraints, increases hospital length of stay, delays rehabilitation, and impedes functional independence. Pharmacological treatments are often considered for agitation management following TBI. Several types of agents have been proposed for the treatment of agitation. However, the benefit and safety of these agents in TBI patients as well as their differential effects and interactions are uncertain. In addition, animal studies and observational studies have suggested impaired cognitive function with the use of certain antipsychotics and benzodiazepines. Hence, a safe and effective treatment for agitation, which does not interfere with neurological recovery, remains to be identified. METHODS/DESIGN: With the help of Health Sciences librarian, we will design a search strategy in the following databases: PubMed, Ovid MEDLINE®, EMBASE, CINAHL, PsycINFO, Cochrane Library, Google Scholar, Directory of Open Access Journals, LILACS, Web of Science, and Prospero. A grey literature search will be performed using the resources suggested in CADTH’s Grey Matters. We will include all randomized controlled, quasi-experimental, and observational studies with control groups. The population of interest is all patients, including children and adults, who have suffered a TBI. We will include studies in which agitation, not further defined, was the presenting symptom or one of the presenting symptoms. We will also include studies where agitation was not the presenting symptom but was measured as an outcome variable and studies assessing the safety of these pharmacological interventions in TBI patients. We will include studies evaluating all pharmacological interventions including beta-adrenergic blockers, typical and atypical antipsychotics, anticonvulsants, dopamine agonists, psychostimulants, antidepressants, alpha-2-adrenergic agonists, hypnotics, and anxiolytics. DISCUSSION: Although agitation is frequent following TBI and pharmacological agents that are often used, there is no consensus on the most efficacious and safest strategy to treat these complications. There is a need for an updated systematic review to summarize the evidence in order to inform practice and future research. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016033140 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13643-016-0374-6) contains supplementary material, which is available to authorized users. BioMed Central 2016-11-17 /pmc/articles/PMC5114826/ /pubmed/27855720 http://dx.doi.org/10.1186/s13643-016-0374-6 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Protocol Williamson, David R. Frenette, Anne Julie Burry, Lisa Perreault, Marc M. Charbonney, Emmanuel Lamontagne, François Potvin, Marie-Julie Giguère, Jean-François Mehta, Sangeeta Bernard, Francis Pharmacological interventions for agitation in patients with traumatic brain injury: protocol for a systematic review and meta-analysis |
title | Pharmacological interventions for agitation in patients with traumatic brain injury: protocol for a systematic review and meta-analysis |
title_full | Pharmacological interventions for agitation in patients with traumatic brain injury: protocol for a systematic review and meta-analysis |
title_fullStr | Pharmacological interventions for agitation in patients with traumatic brain injury: protocol for a systematic review and meta-analysis |
title_full_unstemmed | Pharmacological interventions for agitation in patients with traumatic brain injury: protocol for a systematic review and meta-analysis |
title_short | Pharmacological interventions for agitation in patients with traumatic brain injury: protocol for a systematic review and meta-analysis |
title_sort | pharmacological interventions for agitation in patients with traumatic brain injury: protocol for a systematic review and meta-analysis |
topic | Protocol |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5114826/ https://www.ncbi.nlm.nih.gov/pubmed/27855720 http://dx.doi.org/10.1186/s13643-016-0374-6 |
work_keys_str_mv | AT williamsondavidr pharmacologicalinterventionsforagitationinpatientswithtraumaticbraininjuryprotocolforasystematicreviewandmetaanalysis AT frenetteannejulie pharmacologicalinterventionsforagitationinpatientswithtraumaticbraininjuryprotocolforasystematicreviewandmetaanalysis AT burrylisa pharmacologicalinterventionsforagitationinpatientswithtraumaticbraininjuryprotocolforasystematicreviewandmetaanalysis AT perreaultmarcm pharmacologicalinterventionsforagitationinpatientswithtraumaticbraininjuryprotocolforasystematicreviewandmetaanalysis AT charbonneyemmanuel pharmacologicalinterventionsforagitationinpatientswithtraumaticbraininjuryprotocolforasystematicreviewandmetaanalysis AT lamontagnefrancois pharmacologicalinterventionsforagitationinpatientswithtraumaticbraininjuryprotocolforasystematicreviewandmetaanalysis AT potvinmariejulie pharmacologicalinterventionsforagitationinpatientswithtraumaticbraininjuryprotocolforasystematicreviewandmetaanalysis AT giguerejeanfrancois pharmacologicalinterventionsforagitationinpatientswithtraumaticbraininjuryprotocolforasystematicreviewandmetaanalysis AT mehtasangeeta pharmacologicalinterventionsforagitationinpatientswithtraumaticbraininjuryprotocolforasystematicreviewandmetaanalysis AT bernardfrancis pharmacologicalinterventionsforagitationinpatientswithtraumaticbraininjuryprotocolforasystematicreviewandmetaanalysis |