Background and Objectives
Behavioural and psychological symptoms of dementia (BPSD) contribute significantly to carer stress and often require escalation to pharmacological management. Atypical anti-psychotics are associated with risks of falls, extrapyramidal symptoms, cerebrovascular events and mortality however remain the mainstay of pharmacological management of BPSD. This study aims to explore the perspectives of caregivers and physicians on anti-psychotics in dementia within a community setting.
Research Design
Qualitative approach with semi-structured interviews and written surveys to participants. Eligible participants were caregivers or physicians of patients who were: over 65 years old, prescribed an anti-psychotic medication, had a diagnosis of dementia with BPSD and residing in the community.
Methods
Participants were recruited from SouthCare Aged Care Clinic based at The Sutherland Hospital. Semi-structured phone interviews were held with caregivers and written surveys completed by physicians. Data were analysed, and thematic analysis employed inductively to establish major and subthemes.
Results
30 participants were interviewed, including 12 caregivers, 10 geriatricians and 9 general practitioners. Major themes: a) Positive impact of anti-psychotic medication on dementia management, b) Limited scope of caregiver awareness and education, c) Unique perspectives of physicians on anti-psychotic aversion.
Conclusion and Implications
Despite known risks, anti-psychotics are generally viewed positively by caregivers and physicians. Along with improvement in burden of BPSD, participants perceived the role of anti-psychotics in prevention of institutionalization and stabilising disease progression. Low health literacy and awareness was widely reported amongst caregivers, indicating the need for more active involvement by geriatricians in education and early referral.