Hostname: page-component-7bb8b95d7b-cx56b Total loading time: 0 Render date: 2024-09-20T00:25:13.606Z Has data issue: false hasContentIssue false

We need to do better: most people with dementia living in aged care facilities use antipsychotics for too long, for off-label indications and without documented consent

Published online by Cambridge University Press:  20 March 2020

Lisa M. Kalisch Ellett*
Affiliation:
Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
Renly Lim
Affiliation:
Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia

Abstract

Image of the first page of this content. For PDF version, please use the ‘Save PDF’ preceeding this image.'
Type
Commentary
Copyright
© International Psychogeriatric Association 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Australian Government Department of Health Therapeutic Goods Administration. (2015). Risperidone and risk of cerebrovascular adverse events in dementia patients. Medicines Safety Update, 6(4), 1.Google Scholar
Australian Institute of Health and Welfare. (2018). People leaving aged care. Available from: https://www.gen-agedcaredata.gov.au/www_aihwgen/media/2018-factsheets/People-leaving-aged-care-Fact-sheet-2017%e2%80%9318.pdf; last accessed 19 December 2019.Google Scholar
Brodaty, H.et al. (2018). Antipsychotic deprescription for older adults in long-term care: the HALT study. Journal of the American Medical Directors Association, 19, 592600.CrossRefGoogle ScholarPubMed
Brown, L., Hansnata, E. and La, H. (2017). Economic cost of dementia in Australia 2016-2056. Canberra: NATSEM, Institute for Governance and Policy Analysis, University of Canberra.Google Scholar
Hálfdánarson, Ó.et al. (2017). International trends in antipsychotic use: a study in 16 countries, 2005–2014. European Neuropsychopharmacology, 27(10), 10641076.CrossRefGoogle ScholarPubMed
Harrison, F.et al. (2020). Prolonged use of antipsychotic medications in long-term aged care in Australia: a snapshot from the HALT project. International Psychogeriatrics, 32, 335–345. doi: 10.1017/S1041610219002011.CrossRefGoogle ScholarPubMed
Kalisch Ellett, L.M., Kassie, G.M., Pratt, N.L., Kerr, M. and Roughead, E.E. (2019). Prevalence and duration of use of medicines recommended for short-term use in aged care facility residents. Pharmacy (Basel, Switzerland), 7(2), E55.Google ScholarPubMed
Peisah, C., Jessop, T. and Breen, J. (2020). A missed opportunity to improve practice around the use of restraints and consent in residential aged care: Limitations of the Quality of Care Amendment (Minimising the Use of Restraints) Principles 2019. Australasian Journal on Ageing. doi: 10.1111/ajag.12757.Google Scholar
Pratt, N., Roughead, E.E., Ramsay, E., Salter, A. and Ryan, P. (2011). Risk of hospitalization for hip fracture and pneumonia associated with antipsychotic prescribing in the elderly. Drug Safety, 34(7), 567575.CrossRefGoogle ScholarPubMed
Pratt, N., Roughead, E.E., Ryan, P. and Salter, A. (2010). Antipsychotics and the risk of death in the elderly: an instrumental variable analysis using two preference based instruments. Pharmacoepidemiology and Drug Safety, 19(7), 699707.CrossRefGoogle ScholarPubMed
Royal Australian and New Zealand College of Psychiatrists. (2016). Professional Practice Guideline 10: Antipsychotic medications as a treatment of behavioural and psychological symptoms of dementia. Royal Australian and New Zealand College of Psychiatrists (RANZCP). Available from: https://www.ranzcp.org/files/resources/college_statements/practice_guidelines/pg10-pdf.aspx.Google Scholar
Royal Commission into Aged Care Quality and Safety. (2019). Interim Report. Available from: https://agedcare.royalcommission.gov.au/publications/Pages/interim-report.aspx.Google Scholar
Westaway, K., Sluggett, J., Alderman, C., Moffat, A., Procter, N. and Roughead, E. (2018). The extent of antipsychotic use in Australian residential aged care facilities and interventions shown to be effective in reducing antipsychotic use: a literature review. Dementia (London, England), 1471301218795792.Google ScholarPubMed
Westbury, J.et al. (2018). RedUSE: reducing antipsychotic and benzodiazepine prescribing in residential aged care facilities. Medical Journal of Australia, 208(9), 398403.CrossRefGoogle ScholarPubMed
Yunusa, I., Alsumali, A., Garba, A., Regestein, Q. and Eguale, T. (2019). Assessment of reported comparative effectiveness and safety of atypical antipsychotics in the treatment of behavioral and psychological symptoms of dementia A network meta-analysis. JAMA Network Open, 2(3), e190828.CrossRefGoogle ScholarPubMed