title: A long-term care center interdisciplinary education program for antipsychotic use in dementia: program update five years later.
abstract: BACKGROUND
  While antipsychotic (AP) medications are frequently used in long-term care, current evidence suggests that the risks may offset the benefits, necessitating periodic reassessment of their use. The aims of this present study were: (1) to assess rates of AP use five years after our first intervention to determine the long-term impact; and (2) to implement an updated AP reduction educational intervention program at the same center five years later in order to determine whether AP use could be further reduced.
  
  
  METHODS
  Participants were residents with dementia receiving AP medication. The educational program component included separate lectures on pharmacologic and non-pharmacologic treatment of behavioral and psychological symptoms of dementia (BPSD). Completion of the Nursing Home Behavior Problems Scale (NHBPS), physician interviews concerning AP treatment plans for subjects with dementia, and AP administration and dose assessment occurred both at baseline and again between four to five months after the educational program.
  
  
  RESULTS
  Of 308 long-term residents with dementia, 53 (17.2%) were receiving regular APs, primarily for agitation, aggressivity, other behavioral problems and psychosis. Of these, six died and one was transferred, leaving 46 participants. At five months, ten (21.7%) residents were no longer receiving APs and seven (15.2%) were on a lower dose; thus, 17 (37.0%) were either discontinued or on a lower dose. There was no worsening of NHBPS scores.
  
  
  CONCLUSIONS
  Despite the low prevalence (17.2%) of AP users at the beginning of the current study compared to that observed five years prior (30.5%), it is still possible to further decrease the proportion of users.
authors: Donald Berman Maimonides Geriatric Centre, McGill University, Montreal, Quebec, Canada.
authors: Stephen
authors: S
authors: Vida
authors: Johanne
authors: J
authors: Monette
authors: Machelle
authors: M
authors: Wilchesky
authors: Michèle
authors: M
authors: Monette
authors: Ruby
authors: R
authors: Friedman
authors: Anh
authors: A
authors: Nguyen
authors: Dolly
authors: D
authors: Dastoor
authors: Gabriela
authors: G
authors: Cristache
authors: Nadia
authors: N
authors: Sourial
authors: Lucie
authors: L
authors: Tremblay
authors: Brian
authors: B
authors: Gore
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003704:Dementia / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005852:Geriatric Psychiatry / Q000193:education*; D006801:Humans; D008134:Long-Term Care / Q000379:methods; D008297:Male; D009735:Nursing Homes; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents