For some residents the use of sedative medication will be the appropriate course of action and the benefits will outweigh the risk but the decision rests with the prescribing doctor, writes Patrick Reid.
The peak body for aged care providers is bemused by recent comments by Dr Stephen Judd in relation to the use of antipsychotic drugs in aged care. (AAA, 1 July, Aged Care needs to kick its ‘drug habit’: Judd).
According to the AAA report Dr Judd said attempts to pass off the use of antipsychotics in aged care as simply a doctor-patient issue were “rubbish” and a cop out from the sector.
If Dr Judd has examples where doctors are failing in their duties and simply prescribing serious medication because a staff member requests it; a report must be made. I am sure Dr Judd is aware that there is an obligation to make the Australian Health Practitioner Regulation Agency (AHPRA) aware of any medical professional who ‘places the public at risk because of a significant departure from accepted professional standards’.*
The buck has to stop with the professional who prescribed the medication.
LASA supports the quality use of medicines in conjunction with non-pharmacological approaches and has taken an active role in this regard and has a position on the Steering Group for the RedUSe (Reducing Use of Sedatives) program, developed by the University of Tasmania.
The RedUSe project is in its second phase. The initial program successfully promoted the quality use of sedative medications in residential aged care, using audit, benchmarking, feedback, and a customised education program for staff with interdisciplinary review.
LASA commends the merits of the program to Dr Judd and anyone caring for people with dementia.
With LASA’s support the RedUSe project will involve approximately 150 facilities, nursing staff, prescribing GP, the Community Pharmacist and the Quality Use of Medicines Pharmacist in a range of education, audit and review processes to achieve the most effective interventions to ensure appropriate sedative prescribing.
LASA believes that continuous quality improvement is best dealt with through an open and positive approach. This requires all stakeholders to commit to open dialogue and joint statements wherever possible. I encourage Dr Judd to join us.
LASA is supportive of proven diversional therapies for people with dementia. To this end LASA promotes (through a formal MOU) the work of the Arts Health Institute’s Play Up program that has demonstrated improved outcomes for residents, particularly in that humour therapy can reduce agitation and should be considered as a psychosocial intervention before considering pharmacological intervention.
For some residents the use of sedative medication will be the appropriate course of action and the benefits will outweigh the risk; a decision that will rest with the prescribing doctor.
Patrick Reid is the CEO of Leading Age Services Australia.
*Editor’s note: A recent senate committee inquiry into dementia care received evidence that GPs were prescribing drugs at the behest of facilities that were insufficiently staffed to deal with residents with dementia. See also ‘Senate committee calls for clampdown on restraints’.