A recent Nursing Times articles covers the use of antipsychotic drugs for people with dementia living in care homes. It discusses a review by pharmacists which resulted in the use of these drugs being reduced or discontinued. It covers the risks of antipsychotic medications and reasons for reducing or discontinuing antipsychotics, with a discussion of the role of nurses in medication reviews.
Antipsychotic medication should be prescribed to people with dementia only when there is an identified need and the benefits outweigh the risks. The audit-based service discussed here involved pharmacists, working with nursing and care staff in residential homes. It resulted in antipsychotic dose reductions of 20% and drug discontinuation in 17% of residents with dementia.
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Prentice, A. [and] Wright, D. (2014). Reducing antipsychotic drugs in care homes. Nursing Times, [May 30th 2014] June 4th 2014, 110(22), 12-15.
“5 key points:
- At least 60% of people living in care and nursing homes in the UK have dementia.
- The use of antipsychotic medication in people with dementia is widespread, and causes an additional 1,800 deaths per year.
- Antipsychotic drugs contribute to the anticholinergic burden, which is associated with increased mortality.
- Quetiapine is commonly prescribed for behavioural and psychological symptoms, but its use is unlicensed.
- Working with pharmacists can make nurses more confident in questioning the appropriateness of antipsychotics”.