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Improving psychotropic medication use among persons with dementia

Published online by Cambridge University Press:  23 September 2016

Donovan T. Maust*
Affiliation:
Department of Psychiatry, University of Michigan, Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
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Extract

The use of psychotropic medication among persons with dementia (PWD) both in nursing home (Wetzels et al., 2011) and community settings (Maust et al., 2016) far exceeds what might be expected based on their limited evidence for benefit (Kales et al., 2015). This relatively high use persists despite years of evidence about the potential harms associated with their use in older adults generally and PWD in particular (e.g. Wang et al., 2001; Schneider et al., 2005). However, the solution to relatively high psychotropic use is not to end all psychotropic use, as there are individual patients for whom use of such medication is appropriate. For example, a policy that defines all antipsychotic use as inappropriate may simply lead to increased use of alternatives with even less evidence of benefit, as suggested by the response to antipsychotics’ black box warning in the United States (Kales et al., 2011).

Type
Commentary
Copyright
Copyright © International Psychogeriatric Association 2016 

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References

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