{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T11:55:11Z","timestamp":1773921311287,"version":"3.50.1"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2022,9,4]],"date-time":"2022-09-04T00:00:00Z","timestamp":1662249600000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Dutch Association of Elderly Care Physicians"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Agitation is a common challenging behaviour in dementia with a negative influence on patient\u2019s quality of life and a high caregiver burden. Treatment is often difficult. Current guidelines recommend restrictive use of psychotropic drug treatment, but guideline recommendations do not always suffice.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To explore how physicians decide on psychotropic drug treatment for agitated behaviour in dementia when the guideline prescribing recommendations are not sufficient.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted five online focus groups with a total of 22 elderly care physicians, five geriatricians and four old-age psychiatrists, in The Netherlands. The focus groups were thematically analysed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified five main themes. Transcending these themes, in each of the focus groups physicians stated that there is \u2018not one size that fits all\u2019. The five themes reflect physicians\u2019 considerations when deciding on psychotropic drug treatment outside the guideline prescribing recommendations for agitated behaviour in dementia: (1) \u2018reanalysis of problem and cause\u2019, (2) \u2018hypothesis of underlying cause and treatment goal\u2019, (3) \u2018considerations regarding drug choice\u2019, (4) \u2018trial and error\u2019 and (5) \u2018last resort: sedation\u2019.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>When guideline prescribing recommendations do not suffice, physicians start with reanalysing potential underlying causes. They try to substantiate and justify medication choices as best as they can with a hypothesis of underlying causes or treatment goal, using other guidelines, and applying personalised psychotropic drug treatment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afac189","type":"journal-article","created":{"date-parts":[[2022,9,4]],"date-time":"2022-09-04T17:58:52Z","timestamp":1662314332000},"source":"Crossref","is-referenced-by-count":6,"title":["Psychotropic drug treatment for agitated behaviour in dementia: what if the guideline prescribing recommendations are not sufficient? A qualitative study"],"prefix":"10.1093","volume":"51","author":[{"given":"Margaretha T","family":"Dijk","sequence":"first","affiliation":[{"name":"Department of Medicine for Older People, Amsterdam University Medical Center , Amsterdam , The Netherlands"},{"name":"Amsterdam Public Health, Aging & Later Life , Amsterdam , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Tabak","sequence":"additional","affiliation":[{"name":"Department of Medicine for Older People, Amsterdam University Medical Center , Amsterdam , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cees M P M","family":"Hertogh","sequence":"additional","affiliation":[{"name":"Department of Medicine for Older People, Amsterdam University Medical Center , Amsterdam , The Netherlands"},{"name":"Amsterdam Public Health, Aging & Later Life , Amsterdam , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rob M","family":"Kok","sequence":"additional","affiliation":[{"name":"Department of Old Age Psychiatry, Parnassia Psychiatric Institute , The Hague , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rob J","family":"van Marum","sequence":"additional","affiliation":[{"name":"Department of Medicine for Older People, Amsterdam University Medical Center , Amsterdam , The Netherlands"},{"name":"Amsterdam Public Health, Aging & Later Life , Amsterdam , The Netherlands"},{"name":"Jeroen Bosch Hospital, Geriatric Department and Center for Clinical Pharmacology , 's-Hertogenbosch , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sytse U","family":"Zuidema","sequence":"additional","affiliation":[{"name":"Department of General Practice and Elderly Care Medicine , University of Groningen, , Groningen , The Netherlands"},{"name":"University Medical Center Groningen , University of Groningen, , Groningen , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eefje M","family":"Sizoo","sequence":"additional","affiliation":[{"name":"Department of Medicine for Older People, Amsterdam University Medical Center , Amsterdam , The Netherlands"},{"name":"Amsterdam Public Health, Aging & Later Life , Amsterdam , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Smalbrugge","sequence":"additional","affiliation":[{"name":"Department of Medicine for Older People, Amsterdam University Medical Center , Amsterdam , The Netherlands"},{"name":"Amsterdam Public Health, Aging & Later Life , Amsterdam , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,9,3]]},"reference":[{"key":"2022090417584815800_ref1","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1002\/gps.1722","article-title":"Prevalence of neuropsychiatric symptoms in a large sample of Dutch 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