The impact of reducing sedatives on residents: the rationale for translating sedative reduction into clinical outcomes

BACKGROUND: Psycholeptic (predominantly antipsychotics and benzodiazepines) usage is high in many residential aged care facilities (RACFs). Antipsychotics are often employed to treat behavioural and psychological symptoms of dementia (BPSD) while benzodiazepines are frequently used to alleviate anxiety and sleep disturbances, despite the risk of severe adverse effects and limited efficacy. Antipsychotic reduction has not been shown to worsen or improve BPSD except in sub-groups of residents depending on baseline BPSD severity. Furthermore, research is conflicting as to whether or not psycholeptic reduction diminishes the rates of falls.

AIM: This research aims to observe the impact of psycholeptic reduction on resident clinical outcomes within a multi-strategic project.

METHODS: Currently, a multi-strategic intervention involving auditing, education and review, called the “Reducing the Use of Sedatives” (RedUSe) project, is being expanded nationally to promote appropriate use of psycholeptics in RACFs. While previous interventions have shown success in reducing psycholeptic use in RACFs, few have evaluated the impact on resident clinical outcomes. Changes in BPSD will be monitored through psychometric testing including the Neuropsychiatric Inventory-Nursing Home Version. Baseline measurements will be taken prior to the start of the RedUSe project and repeated after four months. Behaviour and falls rates will be monitored monthly from baseline by a champion nurse at each RACF.

RESULTS/DISCUSSION: Data collection will take place between November 2014 and January 2016. Translating the impact psycholeptic reduction has on resident clinical outcomes within a multi-strategic project is predicted to be of high importance to both the government and research community at large.