May 23, 2018

New Initiative Lowering Antipsychotic Medication In Aged Care Facilities

 

It is scary enough to cope with the change that dementia and ageing brings without having to journey through the complex side-effects of anti-psychotic medication. From falls, strokes, sleep disturbances and agitation, psychotropic agents have great impacts on all, especially seniors.

Pioneered by a team from the Wicking Dementia Research and Education Centre and experts from the University of Tasmania, research initiative, RedUSe, has seen a significant decline in the levels of Antipsychotic medication given to seniors in aged care facilities across Australia.

Published in the Medical Journal of Australia, the exciting results have helped to establish new benchmarks in medication prescription for many of our most vulnerable seniors.

RedUSe as an initiative sought to address the speculation surrounding the levels of antipsychotic and benzodiazepine prescribing in residential aged care facilities (RACFs). The issue of alarmingly high rates of psychotropic prescribing in our aged care homes has been raised across past decades despite significant media and political focus. The team’s primary concern was to examine and evaluate, if any, the impact of a multi-strategic, interdisciplinary intervention on the antipsychotic and benzodiazepine prescribing in RACFs.

RedUSe was conducted over two years and saw an extensive main participant group closely examined. Both consultant pharmacists and community pharmacies were also utilised in the initiative.

The RedUse initiative saw the team create an intervention consisting of a multi-strategic program comprising of a psychototopic medication audit and feedback. Staff across disciplines were provided with further education in relation to the medication and strategic approach.

The levels of antipsychotic and benzodiazepine prescription was initially evaluated at the commencement of the intervention program, then at three months and then at the conclusion of 6 months.

Exciting Results

The RedUSe program saw, across the 150 Australian RACFs involved, sizeable reductions in antipsychotic and benzodiazepine prescribing, without the involvement of substitution to other psychotropic agents.

Of the residents that were taking antipsychotic and benzodiazepine medication at the commencement of the program, almost 40% of those residents were able to have their doses reduced and in particularly exciting cases, were able to cease taking the drugs altogether. This intervention program highlights the possibilities going forward, for medical and aged care staff to co-ordinate care in order to reduce the numbers of seniors being reliant on antipsychotic drugs.

Going Forward

The team have detailed that through focussed interventions, the over-reliance on psychotropic medication for seniors can be helped. They have shown through their findings that it is entirely possible to reduce the use of these often complex and harmful drugs when managing the mental and psychological symptoms of residents in RACFs.  

 

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