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Stip E, Grignon S, Roy MA, Bloom D, Osman O, Amiri L, Abdel Aziz K, Javaid SF, Arnone D. From QAAPAPLE 1 to QAAPAPLE 2: how do we move from one algorithm to another one with Long Acting Antipsychotics (LAIs). Expert Rev Neurother 2020; 20:1325-1332. [PMID: 32962466 DOI: 10.1080/14737175.2020.1826930] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND In 2011, the authors published an algorithm summarizing practice guidelines related to the use of long-acting antipsychotics (LAIs) called the Québec Algorithme Antipsychotique à Action Prolongée (QAAPAPLE), and proposed that it be revised every 5-10 years to update it according to most recent scientific knowledge. Therefore, a re-evaluation of the algorithm was conducted to determine which recommendations were still relevant and which needed modification. METHODS The authors conducted a two-fold approach: a review of the literature to include new evidence since 2011 (controlled trials, meta-analyses, and practice guidelines); and a participatory component involving electronic surveys, conferences, encounters with opinion leadres, and patients' representatives. RESULTS Overall, prescribers tended to make decisions based on personal experience and conversations with colleagues rather than consulting evidence-based guidelines. To test if the algorithm was useful worldwide, it was presented in the United Arab Emirates, where the feedback was in agreement with the algorithm and its limitations. CONCLUSIONS Since its initial publication, the QAAPAPLE algorithm has been updated to guide clinicians on the use of LAIs. The new algorithm has also been assessed outside Canada to test its generalizability worldwide, and indicated its flexibility, efficiency, and user-friendliness in order to guide clinicians on the use of LAIs.
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Affiliation(s)
- Emmanuel Stip
- College of Medicine and Health Sciences, United Arab Emirates University , Al Ain, United Arab Emirates.,Centre Hospitalier Universitaire de Montreal (CHUM), Institute Universitaireen Santé Mentale de Montréal, Université de Montreal, Montreal, Canada
| | - Sylvain Grignon
- Department of Psychiatry, University of Sherbrooke , Sherbrooke, QC, Canada.,Department of Psychiatry, University of Laval , Quebec, QC, Canada
| | - Marc André Roy
- Department of Psychiatry, University of Laval , Quebec, QC, Canada.,Department of Psychiatry, McGill University , Montreal, QC, Canada
| | - David Bloom
- Department of Psychiatry, McGill University , Montreal, QC, Canada
| | - Ossama Osman
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, the University of Texas Health Science Center , Texas, USA
| | - Leena Amiri
- College of Medicine and Health Sciences, United Arab Emirates University , Al Ain, United Arab Emirates
| | - Karim Abdel Aziz
- College of Medicine and Health Sciences, United Arab Emirates University , Al Ain, United Arab Emirates
| | - Syed Fahad Javaid
- College of Medicine and Health Sciences, United Arab Emirates University , Al Ain, United Arab Emirates
| | - Danilo Arnone
- College of Medicine and Health Sciences, United Arab Emirates University , Al Ain, United Arab Emirates.,Kings' College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, Centre for Affective Disorders, London, UK
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