Overprescription a concern

Family members of people with dementia in residential aged care are uncomfortable with the number of medications being prescribed.

Family members of people living with dementia in residential aged care are uncomfortable with the number of medications being prescribed – particularly psychotropics according to a study.

Conducted by the Monash Ageing Research Centre, the study set out to explore what family members knew about their relatives’ drug regimes. Researchers found that most either agreed – 39 per cent – or strongly agreed – 32 per cent – that their relatives were being administered too many medications.

The study participants – listed as next-of-kin of residents who had a diagnosis of dementia – also felt unsure as to whether all the medications were necessary, with a majority agreeable to the number of medications being reduced. They were particularly supportive of deprescribing psychotropic medications, with concerns over side effects appearing to be behind their reasoning.

There is a high prevalence of psychotropic drug use in residential aged care facilities in Australia. A 2018 nationwide study found that 22 per cent of residents were taking an antipsychotic, 22 per cent were taking benzodiazepine and 41 per cent were taking an antidepressant regularly.

In regard to antipsychotic drug use, the figure chimes with the latest quality indicator report in residential aged care which found that – during July-September 2021 – 21.6 per cent of residents used an antipsychotic during the seven-day assessment period in the quarter.

Monash researchers also discovered a gap in family members’ knowledge about medications generally, with just over half of the residents’ medications being recognised by their family – 55 per cent. However, family members were able to identify significantly more non-psychotropic drugs than psychotropic drugs.

The researchers found this discrepancy surprising considering that all of the residents had dementia and nearly all had challenging BPSD (behavioural and psychological symptoms of dementia). This, concluded the researchers, “emphasised the need for psychoeducation among family members”.  

Psychotropic medication deprescribing in residential aged care facilities: An exploratory study of the knowledge and attitudes of family members of residents with dementia is published in the Australasian Journal on Ageing.

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Tags: dementia, featured, Monash Ageing Research Centre, psychotropic drugs,

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