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Pharmacotherapy of Persons with Dementia in Long-term Care in Australia: A Descriptive Audit of Central Nervous System Medications

[ Vol. 12 , Issue. 2 ]

Author(s):

Wendy Moyle, Najwan El Saifi, Brian Draper, Cindy Jones, Elizabeth Beattie, David Shum, Lukman Thalib, Cindy Mervin and Siobhan O’Dwyer   Pages 95 - 102 ( 8 )

Abstract:


Background: Neuropsychiatric symptoms of dementia are often treated through the prescription of one or more psychotropic medications. However, limited efficacy and potential harmful side-effects has resulted in efforts to reduce the use of psychotropic medication in this population, particularly for those living in long-term care.

Objectives: This study sought to describe the pattern of central nervous system medication usage in older adults with dementia living in long-term care; assess the appropriateness of prescribing against Beers criteria; and detect potential drug interactions from co-administered medications.

Methods: A retrospective descriptive audit of the medical records of n=415 residents, aged >60 years with a diagnosis of dementia, from 28 long-term care facilities in Queensland, Australia. Information extracted included the types and usage of regular and Pro Re Nata central nervous system medications.

Results: Of those taking medication (n=317), 68% were prescribed at least one potentially inappropriate medication, and there was a significant positive correlation between the number of medications prescribed and the number of potentially inappropriate medications. Two-hundred potential interactions with variable severity were identified from 130 residents on ≥ 1 medication – 38% were potentially severe interactions, 46% were moderate.

Conclusion: This medication audit raises concerns that prescription of medications may still be the first resort to treat behavioural and psychological symptoms of dementia. There is a need for effective and sustainable person-centred interventions that address barriers for appropriate prescribing practice, and involve the collaboration of all healthcare professionals to optimise prescribing and improve the quality of medicines in older people with dementia.

Keywords:

Dementia, drug interactions, geriatrics, long-term care, medication, prescribing.

Affiliation:

Menzies Health Institute QLD, Griffith University, 2.10 Health Sciences (N48), 170 Kessels Road, Nathan, Brisbane, Queensland, 4111, Menzies Health Institute QLD, Griffith University, Nathan, Brisbane, Queensland, School of Psychiatry, University of New South Wales, Sydney, Menzies Health Institute QLD, Griffith University, Nathan, Brisbane, Queensland, School of Nursing, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Menzies Health Institute QLD, Griffith University, Nathan, Brisbane, Queensland, Department of Public Health, College of Health Sciences, Qatar University, Doha, Menzies Health Institute QLD, Griffith University, Nathan, Brisbane, Queensland, Menzies Health Institute QLD, Griffith University, Nathan, Brisbane, Queensland

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