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An effective approach to reduce antipsychotic and benzodiazepine use in aged care homes: The RedUSe project
Citation
Westbury, JL and Jackson, SL and Peterson, GM, An effective approach to reduce antipsychotic and benzodiazepine use in aged care homes: The RedUSe project, The combined 2009 conference RANZCP and APS conference program, 12-14 November 2009, Bond University, Gold Coast, Queensland, pp. 8. (2009) [Conference Extract]
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Copyright Statement
Copyright 2009 Australian Psychological Society
Official URL: http://www.psychology.org.au/publications/conferen...
Abstract
Psychotropic medications are often prescribed in aged care homes to manage old age mental health
conditions. Antipsychotic drugs are used to treat behavioural and psychological symptoms of dementia
(BPSD), in spite of limited efficacy and increased mortality and stroke risk. Benzodiazepines are
prescribed to treat anxiety and sleep disturbance despite uncertain long-term benefit, dependence
concerns, and increased falls risk. An international review of recent studies of psychotropic utilisation
in aged care homes reported that two thirds of use was inappropriate. To evaluate a multi-faceted,
interdisciplinary intervention to reduce the use of antipsychotics and benzodiazepines in aged care
homes: the 'RedUSe' (Reducing Use of Sedatives) project. The RedUSe project was a controlled trial
conducted in 25 aged care homes in Tasmania. A series of pharmacist-led, 'Quality Use of Medicines'
(QUM) strategies were provided to intervention homes, including two medication audit and feedback
cycles, staff educational sessions and a interdisciplinary sedative review plan. Data on psychotropic
use at each home was collected utilising a customised computer program at baseline, 12 weeks and
26 weeks. An average total of 1591 residents were audited for each RedUSe measurement. Over the
six month trial, there was a significant reduction in the percentage of intervention home residents
regularly taking benzodiazepines (31.8% to 26.9%, p < 0.005) and antipsychotics (20.3% to 18.6%, p
= 0.047), whereas control home antipsychotic and benzodiazepine use did not alter. For residents
taking benzodiazepines and antipsychotics at baseline, there were also significantly more dose
reductions/cessations in intervention homes than in control homes (benzodiazepines: 39.6% vs.
17.6%, p < 0.0001; antipsychotics: 36.9% vs. 20.9%, p = 0.006). Pharmacist and nursing staff
participants reported a high degree of satisfaction with the project. 'RedUSe' led to a significant
reduction in the proportion of residents in aged care homes taking benzodiazepines and
antipsychotics, and a significant increase in the number of dose reductions/cessations of these
agents. Our findings suggest that QUM strategies coordinated through community pharmacies, and
incorporating the dissemination of local data on medication use, offer an effective approach to reduce
psychotropic use in aged care homes.
Item Details
Item Type: | Conference Extract |
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Keywords: | antipsychotic, benzodiazepine, aged care homes, reduse use |
Research Division: | Health Sciences |
Research Group: | Health services and systems |
Research Field: | Aged health care |
Objective Division: | Health |
Objective Group: | Evaluation of health and support services |
Objective Field: | Evaluation of health and support services not elsewhere classified |
UTAS Author: | Westbury, JL (Associate Professor Juanita Breen) |
UTAS Author: | Jackson, SL (Dr Shane Jackson) |
UTAS Author: | Peterson, GM (Professor Gregory Peterson) |
ID Code: | 59135 |
Year Published: | 2009 |
Deposited By: | Pharmacy |
Deposited On: | 2009-11-19 |
Last Modified: | 2013-06-24 |
Downloads: | 6 View Download Statistics |
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