Psychotropic medications, in particular antipsychotics, have limited evidence of clinical benefit in managing behavioural symptoms of dementia. Concurrently, there is clear evidence of adverse outcomes in the same population, including falls, pneumonia, stroke, MI and death (1,2,3). Such medications remain commonly prescribed in residential aged care, with estimates from 13-42% of care recipients (2,4). However, there can be reluctance from care providers and the family of care recipients in ceasing these medications, with concern of escalating behaviours.
In a cohort of recipients of residential aged care with a bedbase of 104 beds, we developed a targeted strategy to reduce prescription of psychotropic medications. This resulted in a reduction in antipsychotic prescriptions from 68% of residents to only 22% over a 12 month period. Simultaneously, there was no increase in reported epsiodes of "concerning behaviour". Rates of polypharmacy were also reduced. There was no discernible change in rates of falls or rates of deaths over the study period.