1. Reducing antipsychotic drugs in care homes
Aileen Prentice Care Services Operations Manager, Boots UK
David Wright Professor of Pharmacy Practice, University of East Anglia
Aim
To reduce inappropriate use of antipsychotics in dementia patients in the care home settings
Plan
Produce an audit based service carried out by specially trained community pharmacists
Demonstrate a reduction in inappropriate antipsychotic usage in dementia patients in care homes Do
Specially trained community pharmacists in the area of antipsychotic medication and dementia
Developed an audit for use in care home setting
Gained consent from the relevant bodies to access the community pharmacy held PMRs
Relevant prework completed by both the community pharmacist and care home managers
Carry out a risk benefit discussion (relating to the relevant NICE/SIGN guidelines for use)
Pharmacist made recommendations e.g. titration for withdrawal and carried out follow up visits at 2-4 months to ascertain the impact of their recommendations
Study
26% of care home residents did not have any symptoms that necessitated regular antipsychotic medication and in 58% of cases the risk of the medication was deemed to outweigh the benefit
Over 20% of residents had their antipsychotic medication reduced
Over 17% of residents had their antipsychotic medication discontinued
These results were in line with the Banerjee paper, 2009
Best results obtained by partnership working with nurse, GP and community pharmacist
It is unlikely that the large reduction seen in such a relatively short period of time would have occurred without the active intervention by the community pharmacist
Act
Ongoing reviews of appropriateness of antipsychotic medications when prescribed for patients with dementia
Raising awareness within the pharmacy profession through the RPS “improving pharmaceutical care in care homes” 2012
Acknowledgements
Aileen Prentice, Care Services Operations Manager, Boots UK
David Wright, Professor of Pharmacy Practice, University of East Anglia
Angela Groome, Care Services pharmacist , Boots UK
References
Banerjee S (2009) The Use of Antipsychotic medication for People with Dementia. Time for Action. London: Department of Health. tinyurl.com/RCPysch-antipsychotic-dementia
Prentice A , Wright D (2014) Reducing antipsychotic drugs in care homes. Nursing Times; 110:23,12-15
Royal Pharmaceutical Society Scotland (2012) Improving Pharmaceutical Care in Care Homes