Psychotropic medicine use high in the community

Psychotropic medicine use is high in people living with dementia in the community, and often not in line with therapeutic guidelines.

This was one of the key findings from a project that reviewed the medication records of people with cognitive impairment who had been discharged from home nursing support.

Lead researcher Dr Dianne Goeman, senior research fellow at the RDNS Institute, said, “We’ve reviewed medication records for 412 people who had a recorded diagnosis of cognitive impairment, Alzheimer’s disease, dementia, or short-term memory loss.

“What we found is that [about] two-thirds, or 61 per cent, of this group had been prescribed psychotropic medicines … and 30 per cent of them were receiving even more than one psychotropic medicine.”

Some of these medicines were prescribed above the recommended doses.

“Previous research has shown that psychotropic medicines can have a sedative effect and can cause falls; this is particularly the case in older people,” Goeman said. “So older people who are prescribed psychotropic medicines are at particularly high risk of stroke, death and accidental overdose. They’re also more likely to end up in hospital.”

The researchers recommended health professionals give greater consideration to the appropriate use and regular review of psychotropic medicines, especially in older people.

The paper stated: “Improved documentation of diagnoses and the indications for prescribing psychotropic medicines is needed, as is greater implementation of educational programmes to support care workers and carers.”

In a separate project, Goeman, along with RDNS Institute staff and Monash University’s Rohan Elliott, reviewed all the evidence about people in the community with medicines that manage cognitive impairment. The evidence revealed sometimes health professionals don’t pick up the early signs of dementia and some don’t assess whether a person can safely manage their medicines.

“Even testing whether people can open medicine packaging is important,” Goeman explained. “Managing medicines is important to staying independent, and making mistakes when taking medicines can have catastrophic effects.”