Evidence-based guidance
Last updated 11 May 2020
COVID-19 is spreading fast around the world. Mental health patients and their clinicians need rapid access to evidence-based information to help to guide their shared decision-making.
Here, we summarise the best available guidance about key COVID-19 questions that frontline mental health clinicians are facing every day. This is not a legal or NHS approved document, but we have followed a rigorous methodological approach to search and select the information (published and unpublished) needed to answer these specific questions.
For more information you can also watch our Q&A video which answers some of the most common questions about the guidance.
This webpage is organised around specific clinical questions. However, we strongly encourage readers to go through the whole document, as all the answers are related. A general link to the evidence source is provided for each question and the full reference list is available in the Appendices.
A table of contents with links to the summaries can be found at the bottom of the page.
We hope that this focussed summary of guidance will be useful and easily accessible. Please consider the guidance within the context of the implications of the pandemic. As always with clinical decisions, use your clinical knowledge, experience and expertise to balance the risks and benefits, taking into account the individual patient’s health, context, and preferences, and the least restrictive option, as the context for implementing the best available evidence.
The application of this guidance is limited to the COVID-19 outbreak and should always be applied in compliance with national and local policies.
Translations and adaptations of the guidance are available also in the following countries:
🇨🇳 China – Peng Xie (Chongqing Medical University)
🇫🇷 France – Astrid Chevance (University of Paris)
🇮🇹 Italy – Armando D’Agostino (University of Milan)
🇹🇷 Turkey – Ayse Kurtulmus (Istanbul Medeniyet University Goztepe Training and Research Hospital)
Please let us know if you find any material errors or important omissions. We would also like your feedback about the usefulness of this guidance. This webpage and the individual tables first went live on April 1st 2020, and we are regularly updating them as new guidance is released and the situation evolves.
Katharine Smith
Edoardo Ostinelli
Orla Macdonald
Andrea Cipriani
Contents
Benzodiazepines and Z-drugs (zopiclone and zolpidem)
Including:
· acute agitation/rapid tranquillisation
· anxiety
· general advice
· insomnia
Clozapine treatment
Including:
· additional risks
· blood testing
· starting phase of a new treatment
· white cell count
Digital technologies and telepsychiatry
Including:
· cultural issues
· digital technologies
· special considerations for older adults, child and adolescents
· telepsychiatry
End of life care
Including:
· management of the different steps of the end of life care
Inpatient wards
Including:
· acutely disturbed patients
· management of suspected/confirmed cases
· older adult inpatient wards
· organisational considerations
· routine care
· venous thromboembolism (VTE) prophylaxis
· vitamin D supplementation
Lithium treatment
Including:
· blood testing
· different formulations
· lithium levels
· starting phase of a new treatment
Long-acting injectable (LAI) antipsychotics
Including:
· management of ongoing treatment
· starting phase of a new treatment
Contact info: Twitter @OxfordPPL
