Validation of the behavioural activity rating scale (BARS)™: a novel measure of activity in agitated patients

Swift, R.H.; Harrigan, E.P.; Cappelleri, Joseph C.; Kramer, Deirdre A.; Chandler, L.P.

doi:10.1016/s0022-3956(01)00052-8

Cited by 127 publications

(32 citation statements)

References 22 publications

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“…However, in a recent naturalistic study in acutely agitated patients, the baseline mean PANSS-EC score was 26.5 (San et al, 2006), and in the present study it was 29, representing much greater agitation. Another recent naturalistic study (Preval et al, 2005) conducted in a psychiatric emergency service reported a mean agitation score of 6.6 on the Behavioral Activity Rating Scale (Swift et al, 2002), which corresponded to 'extremely active, not requiring restraint'. Illness severity was moderate (CGI mean baseline score ¼ 4.6) in a randomized clinical trial in acutely agitated patients with bipolar mania (Meehan et al, 2001), but agitated psychotic patients with bipolar mania or schizophrenia in a naturalistic trial were markedly ill (CGI mean baseline score ¼ 5.5) (San et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

An observational study of the effectiveness and safety of intramuscular olanzapine in the treatment of acute agitation in patients with bipolar mania or schizophrenia/schizoaffective disorder

Centorrino

Meyers

Ahl

et al. 2007

Human Psychopharmacology

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Section: Discussionmentioning

confidence: 99%

An observational study of the effectiveness and safety of intramuscular olanzapine in the treatment of acute agitation in patients with bipolar mania or schizophrenia/schizoaffective disorder

Centorrino

Meyers

Ahl

et al. 2007

Human Psychopharmacology

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“…3 Another scale is the Behavioural Activity Rating Scale or BARS (Table 1). 4 The American Association for Emergency Psychiatry does not consider one agitation rating scale to be better than another, although we find the BARS is easy to use reliably, even for one not trained in psychiatry or emergency medicine. The BARS was created to help assess agitation in pharmaceutical study trials.…”

Section: Level Of Agitationmentioning

confidence: 68%

Medical Evaluation and Triage of the Agitated Patient: Consensus Statement of the American Association for Emergency Psychiatry Project BETA Medical Evaluation Workgroup

Nordstrom¹,

Zun²,

Wilson³

et al. 2012

WestJEM

158

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Numerous medical and psychiatric conditions can cause agitation; some of these causes are life threatening. It is important to be able to differentiate between medical and nonmedical causes of agitation so that patients can receive appropriate and timely treatment. This article aims to educate all clinicians in nonmedical settings, such as mental health clinics, and medical settings on the differing levels of severity in agitation, basic triage, use of de-escalation, and factors, symptoms, and signs in determining whether a medical etiology is likely. Lastly, this article focuses on the medical workup of agitation when a medical etiology is suspected or when etiology is unclear.

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“…The Behavioural Activity Rating Scale (BARS)24 and CGI-Severity22 were used retrospectively to measure behaviour just prior to the injections, and BARS and CGI-Improvement were used at 20–30 min following the injection. Mean BARS score decreased from 6.5±0.7 (violent/continuously active) to 3.1±1.3 (quiet/drowsy) and in 81% of cases, CGI-Improvement was ≤2 (much or very much improved).…”

Section: Resultsmentioning

confidence: 99%

“…Prospective studies used inconsistent outcome measures which included the BARS,24 Children’s Agitation Scale,15 CGI Scale,22 Connor’s teacher scale21 and youth’s report of whether the medication ‘worked’ 28. Retrospective studies made some attempt to measure episode duration, typically interpreting existing nursing notes about activity and agitation level, or reporting commonly recorded metrics such as restraint duration or need for another dose of a PRN.…”

Section: Discussionmentioning

confidence: 99%

What do we really know about PRN use in agitated children with mental health conditions: a clinical review

Baker

Carlson

2018

Evid Based Mental Health

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What is the evidence that ‘pro re nata’ (PRN) medication is effective for ending agitated outbursts in children and adolescents in psychiatric emergency rooms or inpatient units? Literature search was performed for studies of PRN medication use in children and adolescents that included an outcome measure. One randomised controlled trial, three prospective studies and six retrospective studies that included some outcome measure were identified. Outcome measures were heterogeneous, and frequently did not use standardised metrics assessing agitation level to measure effectiveness. The single small Randomized Controlled Trial (RTC) does not find a difference between placebo and medication, and outcomes of other studies do not control for potential placebo effect of the intervention itself as opposed to the medication. There is insufficient evidence to support the common practice of PRN medications for the management of acute agitation, and no data with which to inform clinical practice, such as which medicines and doses are helpful for specific populations or situations. Psychiatrists have no evidence-based medication interventions for acutely managing agitated outbursts in children and adolescents.

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Validation of the behavioural activity rating scale (BARS)™: a novel measure of activity in agitated patients

Cited by 127 publications

References 22 publications

An observational study of the effectiveness and safety of intramuscular olanzapine in the treatment of acute agitation in patients with bipolar mania or schizophrenia/schizoaffective disorder

An observational study of the effectiveness and safety of intramuscular olanzapine in the treatment of acute agitation in patients with bipolar mania or schizophrenia/schizoaffective disorder

Medical Evaluation and Triage of the Agitated Patient: Consensus Statement of the American Association for Emergency Psychiatry Project BETA Medical Evaluation Workgroup

What do we really know about PRN use in agitated children with mental health conditions: a clinical review

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