Poster Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2025
Effect of introducing an antipsychotic deprescribing educational intervention targeting staff managing hospital inpatients with dementia (119813)
Aims The primary aim was to evaluate the effectiveness of implementing an antipsychotic deprescribing algorithm targeting staff managing inpatients with dementia by auditing frequency of: (a) dose reduction of antipsychotic drugs, (b) documented weaning recommendations in discharge summaries and (c) documented weaning recommendations by pharmacists.
The secondary aim was to explore staff’s perceptions of the algorithm to understand factors influencing its uptake.
Methods This was a mixed method study. Part 1 audited patient data pre-intervention and post-intervention. Part 2 surveyed staff pre-intervention and post-intervention. The educational intervention involved cards, posters, emails and presentations based on an algorithm from Canadian Family Physician.
Results Part 1 included 27 patients pre-intervention and 39 patients post-intervention. It identified a discernible, but not statistically significant, trend towards doctors making increased deprescribing recommendations in discharge summaries (P=0.195). There was no statistically significant change in frequency of antipsychotic dose reduction (P=0.367) or weaning recommendations by pharmacists (P=0.409).
Part 2 included 31 staff pre-intervention and 41 staff post-intervention. It found doctors and pharmacists regarded the algorithm positively (Figure 1). However, staff identified multiple barriers to deprescribing including perceptions of irrelevance, pressure from multidisciplinary team members, time and resource limitations (Table 1).
Conclusions While this study did not demonstrate a statistically significant response to an inpatient antipsychotic deprescribing educational intervention, the trend towards increased deprescribing recommendations in discharge summaries could be explored with longitudinal community-based studies. Future studies could assess interventions involving automated electronic alerts, antipsychotic stewardship programs or deprescribing ‘champions’ (Table 2).
