Recent years have seen a rapidly increasing trend towards the delivery of health technology through mobile devices.Smartphones and tablet devices are thus becoming increasingly popular for accessing information and a ...Recent years have seen a rapidly increasing trend towards the delivery of health technology through mobile devices.Smartphones and tablet devices are thus becoming increasingly popular for accessing information and a wide range of services,including health care services.Modern mobile apps can be used for a variety of reasons,ranging from education for the patients and assistance to clinicians to delivery of interventions.Mobile phone apps have also been established to benefit patients in a scope of interventions across numerous medical specialties and treatment modalities.Medical apps have their advantages and disadvantages.It is important that clinicians have access to knowledge to make decisions regarding the use of medical apps on the basis of risk-benefit ratio.Mobile apps that deliver psycho social interventions offer unique challenges and opportunities.A number of reviews have highlighted the potential use of such apps.There is a need to describe,report and study their side effects too.The adverse effects associated with these apps can broadly be divided into:(1)those resulting from the security and safety concerns;(2)those arising from the use of a particular psycho social intervention;and(3)those due to the interaction with digital technology.There is a need to refine and reconsider the safety and adverse effects in this area.The safety profile of a mobile PSI app should describe its safety profile in:(1)privacy and security;(2)adverse effects of psychotherapy;and(3)adverse effects unique to the use of apps and the internet.This is,however,a very new area and further research and reporting is required to inform clinical decision making.展开更多
Objective: Evidence base for rapid tranquillisation is an under researched area. Guidelines on rapid tranquilisation from English speaking countries were appraised using AGREE (Appraisal of Guidelines Research and Eva...Objective: Evidence base for rapid tranquillisation is an under researched area. Guidelines on rapid tranquilisation from English speaking countries were appraised using AGREE (Appraisal of Guidelines Research and Evaluation) and differences in their recommendations were analysed. Methods: Four independent psychiatrists appraised the guidelines using the AGREE tool. AGREE is a validated instrument used to assess the quality of guideline and recommendations using six domains of which each domain captures a specific aspect of the guideline development. The content was analysed manually. Results: Seven guidelines from five English speaking countries met the inclusion criteria. All the guidelines scored well on the domain of “scope and purpose”. NICE guidelines from the UK consistently scored well on all domains with the maximum possible score of 100 on the “applicability” domain. APA from the USA did well on the domain of “editorial independence”. AGREE could only examine the guideline development process and not the content. The guidelines differed in their recommendations of choice of drug for rapid tranquillisation. Discussion: All guidelines scored reasonably well on AGREE. National Institute of Clinical Excellence (NICE) has used robust strategies in developing the guidelines. Guidelines failed to achieve consensus in recommendations despite using a common pool of evidence. Haloperidol-promethazine combination is not recommended by any with the exception of NICE. This suggests data is selectively interpreted depending on locally prevalent customs.展开更多
文摘Recent years have seen a rapidly increasing trend towards the delivery of health technology through mobile devices.Smartphones and tablet devices are thus becoming increasingly popular for accessing information and a wide range of services,including health care services.Modern mobile apps can be used for a variety of reasons,ranging from education for the patients and assistance to clinicians to delivery of interventions.Mobile phone apps have also been established to benefit patients in a scope of interventions across numerous medical specialties and treatment modalities.Medical apps have their advantages and disadvantages.It is important that clinicians have access to knowledge to make decisions regarding the use of medical apps on the basis of risk-benefit ratio.Mobile apps that deliver psycho social interventions offer unique challenges and opportunities.A number of reviews have highlighted the potential use of such apps.There is a need to describe,report and study their side effects too.The adverse effects associated with these apps can broadly be divided into:(1)those resulting from the security and safety concerns;(2)those arising from the use of a particular psycho social intervention;and(3)those due to the interaction with digital technology.There is a need to refine and reconsider the safety and adverse effects in this area.The safety profile of a mobile PSI app should describe its safety profile in:(1)privacy and security;(2)adverse effects of psychotherapy;and(3)adverse effects unique to the use of apps and the internet.This is,however,a very new area and further research and reporting is required to inform clinical decision making.
文摘Objective: Evidence base for rapid tranquillisation is an under researched area. Guidelines on rapid tranquilisation from English speaking countries were appraised using AGREE (Appraisal of Guidelines Research and Evaluation) and differences in their recommendations were analysed. Methods: Four independent psychiatrists appraised the guidelines using the AGREE tool. AGREE is a validated instrument used to assess the quality of guideline and recommendations using six domains of which each domain captures a specific aspect of the guideline development. The content was analysed manually. Results: Seven guidelines from five English speaking countries met the inclusion criteria. All the guidelines scored well on the domain of “scope and purpose”. NICE guidelines from the UK consistently scored well on all domains with the maximum possible score of 100 on the “applicability” domain. APA from the USA did well on the domain of “editorial independence”. AGREE could only examine the guideline development process and not the content. The guidelines differed in their recommendations of choice of drug for rapid tranquillisation. Discussion: All guidelines scored reasonably well on AGREE. National Institute of Clinical Excellence (NICE) has used robust strategies in developing the guidelines. Guidelines failed to achieve consensus in recommendations despite using a common pool of evidence. Haloperidol-promethazine combination is not recommended by any with the exception of NICE. This suggests data is selectively interpreted depending on locally prevalent customs.
