Adolescence transitional care in neurogenic detrusor overactivity and the use of OnabotulinumtoxinA: A clinical algorithm from an Italian consensus statement

Abstract

This manuscript represents the first report on the onaBNTa in adolescents. Young adults should be treated as a distinct sub-population in policy, planning, programming, and research, as strongly sustained by national public health care. This consensus and the algorithm could support multidisciplinary communication, reduce the extent of variations in clinical practice and optimize clinical decision making.

Optimizing therapeutic decision‐making for off‐label medicines use: A scoping review and consensus recommendations for improving practice and research+

“…Of these, 21 (68% of total) publications refer to 20 unique guidances providing general considerations, frameworks, and recommendations to guide decision‐making for off‐label medicines use 8,14–17,22–37 . Ten papers (32%) provided off‐label use recommendations for specific medicines or therapeutic categories but also described the types of evidence, expertise, and processes used in developing recommendations and thus were included 38–47 …”

“…Only four papers used systematic consensus development processes 41,45–47 . Multidisciplinary panels always included clinicians, usually specializing in the therapeutic area under consideration.…”

“…8,[14][15][16][17][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] Ten papers (32%) provided off-label use recommendations for specific medicines or therapeutic categories but also described the types of evidence, expertise, and processes used in developing recommendations and thus were included. [38][39][40][41][42][43][44][45][46][47] 3.1.2 | Thematic concepts of general guidances for off-label medicine use…”

“…40,42 Only four papers used systematic consensus development processes. 41,[45][46][47] Multidisciplinary panels always included clinicians, usually specializing in the therapeutic area under consideration. Fewer reported participants with other relevant expertise, such as evidencebased medicine, practice guideline development, 41 or patient advocacy.…”

Can we improve our management of dysfunctional voiding in children and adults: International Consultation on Incontinence Research Society; ICI‐RS2018?

“…">Alpha blocker administration or botulinum toxin sphincter injection has been suggested in male patients while the medication is not recommended for the majority of pediatric patients or is used as an adjunct treatment option only . A standard common approach could be useful to avoid more invasive treatments such as bladder augmentation or sphincterotomy, which are very rarely justified …”