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Cultural change needed to curb antipsychotic drug misuse

Regulation alone will not stop the overuse of antipsychotic drugs to manage the behaviour of people with dementia in aged care facilities, Australia’s chief medical officer says.

Professor Brendan Murphy said cultural change and the education of doctors is needed.

Murphy said there needed to be cultural change in those residential aged care facilities that did not have alternative strategies to manage behaviours related to dementia.

“You can’t just take away the drugs from a facility that doesn’t have alternative strategies, so I think it’s a broad cultural approach across the whole industry,” he told the aged care royal commission in Sydney.

The inquiry heard experts on an aged care clinical advisory committee noted only a small proportion of the antipsychotic drugs that were prescribed, estimated at about 10 per cent of the current use, was clearly justified.

“The sense was that in their clinical experience, in probably eight to nine out of 10 cases you probably didn’t need and shouldn’t be using those drugs, so it was merely an estimate,” Murphy said.

New quality standards come into effect on July 1 to better regulate and minimise the use of chemical and physical restraints in aged care facilities.

Murphy said he planned to send letters to doctors who appeared to be overprescribing antipsychotics, as part of a broader strategy to educate all general practitioners who work in aged care.

“What we’re relying on is cultural change and education. That is going to make the biggest difference.

“Those regulations will help and they will prompt and they will guide, but you will not make material change in this as in any other area of medical practice without the doctors being involved in that cultural change.”

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