Evidence-Informed Approach to De-Prescribing of Atypical Antipsychotics (AAP) in the Management of Behavioral Expressions (BE) in Advanced Neurocognitive Disorders (NCD): Results of a Retrospective Study
The LuBAIR™ Paradigm is a novel approach to ascribe meaning to behavioral expressions in advanced neurocognitive disorders when the reliability of a clinical assessment is limited. The meaning ascribed to each behavioral category was used to identify those which are likely to respond to the use of a...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-01-01
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| Series: | Geriatrics |
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| Online Access: | https://www.mdpi.com/2308-3417/7/1/14 |
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| author | Atul Sunny Luthra Raymond LinBin Gao Shannon Remers Peter Carducci Joanna Sue |
| author_facet | Atul Sunny Luthra Raymond LinBin Gao Shannon Remers Peter Carducci Joanna Sue |
| author_sort | Atul Sunny Luthra |
| collection | DOAJ |
| description | The LuBAIR™ Paradigm is a novel approach to ascribe meaning to behavioral expressions in advanced neurocognitive disorders when the reliability of a clinical assessment is limited. The meaning ascribed to each behavioral category was used to identify those which are likely to respond to the use of atypical antipsychotics, in their management. De-prescribing was attempted on patients who qualified to enter this retrospective study. De-prescribing was defined as successful if individuals were completely withdrawn from AAP and remained off them for 60 days, without the re-emergence of behaviors. The LuBAIR™ Inventory was filled on two occasions. The data collected on the second occasion, in the successful and failed de-prescribed groups, were compared in this retrospective study. MANOVA, Chi-Square paired <i>t</i>-test statistical analyses were used to detect the differences in the behavioral categories between the two cohorts. Cohen d was used to measure effect size. Patients who did not have Mis-Identification and Goal-Directed Expressions were more likely to successfully de-prescribe: X2 (1, <i>N</i> = 40) = 29.119 <i>p</i> < 0.0001 and X2 (1, <i>N</i> = 40) = 32.374, <i>p</i> < 0.0001, respectively. Alternatively, the same behavioral categories were more likely to be present in patients who failed de-prescribing: MANOVA and paired <i>t</i>-test (<i>p</i> < 0.0001). Atypical antipsychotics, in their role as an antipsychotic and mood stabilizer, may be used to manage Mis-Identification and Goal-Directed Expressions, respectively. |
| first_indexed | 2024-03-09T21:51:03Z |
| format | Article |
| id | doaj.art-9525e68319744544a8b7d3f7830c1ad4 |
| institution | Directory Open Access Journal |
| issn | 2308-3417 |
| language | English |
| last_indexed | 2024-03-09T21:51:03Z |
| publishDate | 2022-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Geriatrics |
| spelling | doaj.art-9525e68319744544a8b7d3f7830c1ad42023-11-23T20:07:31ZengMDPI AGGeriatrics2308-34172022-01-01711410.3390/geriatrics7010014Evidence-Informed Approach to De-Prescribing of Atypical Antipsychotics (AAP) in the Management of Behavioral Expressions (BE) in Advanced Neurocognitive Disorders (NCD): Results of a Retrospective StudyAtul Sunny Luthra0Raymond LinBin Gao1Shannon Remers2Peter Carducci3Joanna Sue4Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8M 1W9, CanadaSt. Peters Hospital, Hamilton, ON L8M 1W9, CanadaHomewood Health Inc., Guelph, ON N1E 6K9, CanadaSchool of Pharmacy, University of Waterloo, Waterloo, ON N2G 1C5, CanadaSt. Peters Hospital, Hamilton, ON L8M 1W9, CanadaThe LuBAIR™ Paradigm is a novel approach to ascribe meaning to behavioral expressions in advanced neurocognitive disorders when the reliability of a clinical assessment is limited. The meaning ascribed to each behavioral category was used to identify those which are likely to respond to the use of atypical antipsychotics, in their management. De-prescribing was attempted on patients who qualified to enter this retrospective study. De-prescribing was defined as successful if individuals were completely withdrawn from AAP and remained off them for 60 days, without the re-emergence of behaviors. The LuBAIR™ Inventory was filled on two occasions. The data collected on the second occasion, in the successful and failed de-prescribed groups, were compared in this retrospective study. MANOVA, Chi-Square paired <i>t</i>-test statistical analyses were used to detect the differences in the behavioral categories between the two cohorts. Cohen d was used to measure effect size. Patients who did not have Mis-Identification and Goal-Directed Expressions were more likely to successfully de-prescribe: X2 (1, <i>N</i> = 40) = 29.119 <i>p</i> < 0.0001 and X2 (1, <i>N</i> = 40) = 32.374, <i>p</i> < 0.0001, respectively. Alternatively, the same behavioral categories were more likely to be present in patients who failed de-prescribing: MANOVA and paired <i>t</i>-test (<i>p</i> < 0.0001). Atypical antipsychotics, in their role as an antipsychotic and mood stabilizer, may be used to manage Mis-Identification and Goal-Directed Expressions, respectively.https://www.mdpi.com/2308-3417/7/1/14neurocognitive disordersBehavior Expressions (BE)atypical antipsychotic medications (AAP)LuBAIR™ Paradigm and LuBAIR™ Inventory |
| spellingShingle | Atul Sunny Luthra Raymond LinBin Gao Shannon Remers Peter Carducci Joanna Sue Evidence-Informed Approach to De-Prescribing of Atypical Antipsychotics (AAP) in the Management of Behavioral Expressions (BE) in Advanced Neurocognitive Disorders (NCD): Results of a Retrospective Study Geriatrics neurocognitive disorders Behavior Expressions (BE) atypical antipsychotic medications (AAP) LuBAIR™ Paradigm and LuBAIR™ Inventory |
| title | Evidence-Informed Approach to De-Prescribing of Atypical Antipsychotics (AAP) in the Management of Behavioral Expressions (BE) in Advanced Neurocognitive Disorders (NCD): Results of a Retrospective Study |
| title_full | Evidence-Informed Approach to De-Prescribing of Atypical Antipsychotics (AAP) in the Management of Behavioral Expressions (BE) in Advanced Neurocognitive Disorders (NCD): Results of a Retrospective Study |
| title_fullStr | Evidence-Informed Approach to De-Prescribing of Atypical Antipsychotics (AAP) in the Management of Behavioral Expressions (BE) in Advanced Neurocognitive Disorders (NCD): Results of a Retrospective Study |
| title_full_unstemmed | Evidence-Informed Approach to De-Prescribing of Atypical Antipsychotics (AAP) in the Management of Behavioral Expressions (BE) in Advanced Neurocognitive Disorders (NCD): Results of a Retrospective Study |
| title_short | Evidence-Informed Approach to De-Prescribing of Atypical Antipsychotics (AAP) in the Management of Behavioral Expressions (BE) in Advanced Neurocognitive Disorders (NCD): Results of a Retrospective Study |
| title_sort | evidence informed approach to de prescribing of atypical antipsychotics aap in the management of behavioral expressions be in advanced neurocognitive disorders ncd results of a retrospective study |
| topic | neurocognitive disorders Behavior Expressions (BE) atypical antipsychotic medications (AAP) LuBAIR™ Paradigm and LuBAIR™ Inventory |
| url | https://www.mdpi.com/2308-3417/7/1/14 |
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