title: Physicians' practice and familiarity with treatment for agitation associated with dementia in Israeli nursing homes.
abstract: BACKGROUND
  To clarify physicians' actual practice in treating agitation in the nursing home and to elucidate the relationship between background factors, familiarity with interventions, and practice.
  
  
  METHODS
  A survey of actual practice for agitation in persons with dementia was administered to 67 physicians aged 31-70+ working in nursing homes in Israel. Questionnaires were administered by personal interview, self-completed, or a combination of the two.
  
  
  RESULTS
  Psychotropic medications are prescribed by 92.5% of physicians for treating agitation, most notably, Haloperidol (39%). Non-pharmacological treatment was also reported to be common, though to a lesser extent, with environmental change being the most prevalent non-pharmacological intervention. Generally, physicians showed low familiarity levels with non-pharmacological interventions, with higher levels noted for physicians with a specialty in geriatrics compared to those who were non-specialized. Physicians who were non-Israeli and younger also reported higher familiarity levels compared to their respective counterparts (i.e. Israeli and older) but this difference did not reach significance.
  
  
  CONCLUSIONS
  The findings indicate that, despite current guidelines, psychotropic medications are the treatment of choice among nursing home physicians in Israel. While rates of use of non-pharmacological interventions are substantial, their in-practice application may be hindered by lack of familiarity as well as system barriers. The results have implications for system and education changes.
authors.affiliation: Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. herczeg@post.tau.ac.il
authors.forename: Jiska
authors.initials: J
authors.lastname: Cohen-Mansfield
authors.forename: Atarah
authors.initials: A
authors.lastname: Juravel-Jaffe
authors.forename: Aaron
authors.initials: A
authors.lastname: Cohen
authors.forename: Iris
authors.initials: I
authors.lastname: Rasooly
authors.forename: Hava
authors.initials: H
authors.lastname: Golander
mesh_terms: D000328:Adult; D000368:Aged; D002983:Clinical Competence / Q000592:standards; D003704:Dementia / Q000150:complications*; D004779:Environment Design / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D015577:Geriatric Assessment; D019983:Guideline Adherence; D040261:Harm Reduction; D019538:Health Care Surveys; D006299:Health Services for the Aged; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009735:Nursing Homes / Q000592:standards / Q000706:statistics & numerical data; D010820:Physicians / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards; D011595:Psychomotor Agitation / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D011619:Psychotropic Drugs / Q000145:classification / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D000078329:Workforce
chemical_list: D011619:Psychotropic Drugs