Quality use of antipsychotic medicines in residential aged care facilities in New Zealand

Henry C. Ndukwe, Prasad S. Nishtala, Ting Wang, June M. Tordoff

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

INTRODUCTION: Antipsychotic medicines are used regularly or when required in residential aged care facilities to treat symptoms of dementia, but have been associated with several adverse effects. AIM: The aim of this study was to examine ‘quality use’ of antipsychotic medicines in residential aged care facilities in New Zealand, by surveying nurse managers. METHODS: A cross-sectional survey was mailed to 318 nurse managers working in a nationally representative sample of aged care facilities. A purpose-developed, pre-tested, 22-item structured questionnaire was used to explore practice related to the quality use of antipsychotic medicines. RESULTS: Overall, 31.4% of nurse managers responded to the survey. They mostly (88%) had ≥ 1 year’s relevant work experience and 83% of facilities provided care for those within the range of 21 to 100 residents. Respondents reported that staff education on dementia management occurred early in employment. Two-thirds of participants reported non-pharmacological interventions were commonly used for managing challenging behaviours, while less than half (45%) cited administering antipsychotic medicine. Respondents reported ‘managing behavioural symptoms’ (81%) as one of the main indications for antipsychotic use. Frequently identified adverse effects of antipsychotic medicines were drowsiness or sedation (64%) and falls (61%). Over 90% reported general practitioners reviewed antipsychotic use with respect to residents’ target behaviour 3-monthly, and two-thirds used an assessment tool to appraise residents’ behaviour. DISCUSSION: Staff education on dementia management soon after employment and resident 3-monthly antipsychotic medicine reviews were positive findings. However, a wider use of behavioural assessment tools might improve the care of residents with dementia and the quality use of antipsychotic medicines.

Original languageEnglish
Pages (from-to)335-343
Number of pages9
JournalJournal of Primary Health Care
Volume8
Issue number4
DOIs
Publication statusPublished - 1 Dec 2016

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Keywords

  • Adverse effects
  • Antipsychotic medicines
  • Challenging behaviour
  • Non-pharmacologic interventions
  • Quality use
  • Residential aged care facilities

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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