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A cross-sectional examination of the prevalence of psychotropic medications for people living with dementia in Australian long-term care facilities: issues of concern

Published online by Cambridge University Press:  04 December 2017

Mitchell McMaster ,
Elaine Fielding ,
David Lim ,
Wendy Moyle Open the ORCID record for Wendy Moyle [Opens in a new window] ,
Elizabeth Beattie  and
The AusQoL Group
Mitchell McMaster*
Affiliation:
Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia
Elaine Fielding
Affiliation:
Dementia Collaborative Research Centre: Carers and Consumers, Queensland University of Technology, Brisbane, Australia
David Lim
Affiliation:
Flinders Rural Health SA, Flinders University, Victor Harbor, Australia
Wendy Moyle
Affiliation:
Menzies Health Institute Queensland, Griffith University, Nathan, Australia
Elizabeth Beattie
Affiliation:
Dementia Collaborative Research Centre: Carers and Consumers, Queensland University of Technology, Brisbane, Australia
The AusQoL Group
Affiliation:
Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia Dementia Collaborative Research Centre: Carers and Consumers, Queensland University of Technology, Brisbane, Australia Flinders Rural Health SA, Flinders University, Victor Harbor, Australia Menzies Health Institute Queensland, Griffith University, Nathan, Australia
*
Correspondence should be addressed to: Mitchell McMaster, Centre for Research on Ageing, Health and Wellbeing, Florey Building #54, Mills Rd, Acton, ACT, 2602. Phone: +61-2-61256351; Fax: +61-2-61251558. Email: mitchell.mcmaster@anu.edu.au.
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Abstract

Background:

Behavioral and psychological symptoms of dementia (BPSD) are a common problem in long-term care facilities (LTC). Clinical guidelines dictate that first-line treatments for BPSD are psychosocial and behavioral interventions; if these are unsuccessful, psychotropic medications may be trialed at low doses and their effects can be monitored.

Methods:

There have previously been no studies with nationally representative samples to investigate psychotropic administration in LTCs in Australia. This study determines the prevalence of psychotropic administration in a representative stratified random sample of 446 residents living with dementia from 53 Australian LTCs. Questionnaire and medical chart data in this study is drawn from a larger cross-sectional, mixed methods study on quality of life in Australian LTCs.

Results:

It was found that 257 (58%) residents were prescribed psychotropic medications including: antipsychotics (n = 160, 36%), benzodiazepines (n = 136, 31%), antidepressants (n = 117, 26%), and anti-dementia medications (n = 9, 2%). BPSD were found to be very common in the sample, with 82% (n = 364) of participants experiencing at least one BPSD. The most prevalent BPSD were depression (n = 286, 70%) and agitation (n = 299, 67%).

Conclusions:

Although detailed background information was not collected on individual cases, the prevalence found is indicative of systematic industry-wide, over-prescription of psychotropic medications as a first-line treatment for BPSD. This study highlights a clear need for further research and interventions in this area.

Keywords

dementiaBPSDpsychotropic medicationantipsychoticsbenzodiazepinesantidepressants
Type
Original Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 7: Issue Theme: Benzodiazepines and Hypnotics , July 2018 , pp. 1019 - 1026
Copyright
Copyright © International Psychogeriatric Association 2017 

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