title: A 12-month follow-up study of "RedUSe": a trial aimed at reducing antipsychotic and benzodiazepine use in nursing homes.
abstract: BACKGROUND
  To assess the long-term impact of the "Reducing Use of Sedatives" (RedUSe) trial on antipsychotic and benzodiazepine prevalence and dosage.
  
  
  METHODS
  RedUSe was a six-month controlled trial conducted in 25 Tasmanian nursing homes in 2008-9 which led to significant reductions in benzodiazepine and antipsychotic use and a doubling of dose reductions of these agents. In a follow-up study, data on psychotropic use was collected from all nursing homes a year after the final RedUSe measure. Mean daily doses for each home were calculated by converting antipsychotic and benzodiazepine doses to chlorpromazine and diazepam equivalents, respectively. To determine the long-term impact of the project, 6-month and initial baseline data were compared to the 18-month follow-up data.
  
  
  RESULTS
  1578 residents were audited for the follow-up measure. In the 18 months since the RedUSe project was instigated, benzodiazepine prevalence fell by 25% in intervention nursing homes. Similarly, the mean daily diazepam equivalence in these homes had fallen by 24%. In contrast, after a significant reduction during the RedUSe trial, antipsychotic prevalence returned to baseline levels in intervention nursing homes, with mean chlorpromazine equivalence remaining relatively constant with time. There was a delayed reduction in benzodiazepine and antipsychotic use in the control homes.
  
  
  CONCLUSIONS
  Both benzodiazepine usage and mean daily diazepam equivalence continued to decline in intervention nursing homes in the year following the RedUSe trial. However, the effect of the RedUSe intervention on antipsychotic prevalence and dosage was not sustained.
authors.affiliation: Unit for Medication Outcomes, Research and Education, School of Pharmacy, University of Tasmania, Sandy Bay, Tasmania, Australia. Juanita.Westbury@utas.edu.au
authors.forename: Juanita
authors.initials: J
authors.lastname: Westbury
authors.forename: Lisette
authors.initials: L
authors.lastname: Tichelaar
authors.forename: Gregory
authors.initials: G
authors.lastname: Peterson
authors.forename: Peter
authors.initials: P
authors.lastname: Gee
authors.forename: Shane
authors.initials: S
authors.lastname: Jackson
mesh_terms: D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use*; D002746:Chlorpromazine / Q000627:therapeutic use; D003975:Diazepam / Q000627:therapeutic use; D005500:Follow-Up Studies; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008134:Long-Term Care / Q000706:statistics & numerical data; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D013648:Tasmania
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D003975:Diazepam; D002746:Chlorpromazine