title: Effect of an interdisciplinary educational program on antipsychotic prescribing among nursing home residents with dementia.
abstract: OBJECTIVE
  To assess the effect of an interdisciplinary educational program in reducing the use of antipsychotics in nursing home residents with dementia.
  
  
  METHODS
  We conducted a longitudinal pilot study to test the implementation of a 7-month interdisciplinary educational program in a fixed cohort of residents with dementia receiving antipsychotics. The program included consciousness-raising, educational sessions, and clinical follow-up. Administrators, physicians, pharmacists, nursing staff, and personal care attendants were involved. The effect of the program was assessed over a 6-month period, in terms of the proportion of discontinuations and dose reductions of antipsychotics. Repeated measures for use of other psychotropics and restraints, frequency of disruptive behaviors, and stressful events experienced by nursing staff and personal care attendants were simultaneously assessed.
  
  
  RESULTS
  Among the 81 residents still present at the end of the program, there were 40 (49.4%) discontinuations and 11 (13.6%) dose reductions. No significant changes were found in the use of other psychotropics, the use of restraints, or in the number of stressful events experienced by nursing staff and personal care attendants. The frequency of disruptive behaviors decreased significantly over the 6-month period (p<0.001).
  
  
  CONCLUSIONS
  Our interdisciplinary educational program led to a substantial reduction in the number of residents receiving antipsychotics and to a decrease in the frequency of disruptive behaviors. Our findings suggest that implementation of recognized practice guidelines could be an effective way to target residents who might not benefit from antipsychotics or who may tolerate a dose reduction.
authors.affiliation: Division of Geriatric Medicine, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec, Canada. johanne.monette@mcgill.ca
authors.forename: Johanne
authors.initials: J
authors.lastname: Monette
authors.forename: Nathalie
authors.initials: N
authors.lastname: Champoux
authors.forename: Michèle
authors.initials: M
authors.lastname: Monette
authors.forename: Lynn
authors.initials: L
authors.lastname: Fournier
authors.forename: Christina
authors.initials: C
authors.lastname: Wolfson
authors.forename: Guillaume Galbaud
authors.initials: GG
authors.lastname: du Fort
authors.forename: Nadia
authors.initials: N
authors.lastname: Sourial
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Le Cruguel
authors.forename: Brian
authors.initials: B
authors.lastname: Gore
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D003704:Dementia / Q000188:drug therapy* / Q000451:nursing / Q000523:psychology; D004334:Drug Administration Schedule; D004363:Drug Utilization / Q000706:statistics & numerical data; D004502:Education, Medical, Continuing / Q000379:methods; D004509:Education, Nursing, Continuing / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005851:Geriatric Nursing / Q000193:education; D006707:Homes for the Aged / Q000592:standards*; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000592:standards*; D009740:Nursing Staff / Q000193:education; D010348:Patient Care Team; D010865:Pilot Projects; D015397:Program Evaluation; D011792:Quebec
chemical_list: D014150:Antipsychotic Agents