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Int Psychogeriatr. 2015 Nov;27(11):1849-59. doi: 10.1017/S1041610215000745. Epub 2015 Jun 10.

A consensus guideline for antipsychotic drug use for dementia in care homes. Bridging the gap between scientific evidence and clinical practice.

Author information

1
Department of General Practice,University Medical Center Groningen,University of Groningen,Groningen,the Netherlands.
2
Department of Primary and Community Care,Centre for Family Medicine,Geriatric Care and Public Health,Radboud University Medical Centre,Nijmegen,the Netherlands.
3
Norwegian National Advisory Unit of Ageing and Health,Vestfold Hospital Trust,T√łnsberg,Norway;Centre for Old Age Psychiatry Research,Innlandet Hospital Trust,Ottestad,Norway;Institute of Clinical Medicine,Campus AHUS,University of Oslo,Norway.
4
UK Alzheimer's Society,London,UK.
5
Faculty of Medical and Human Sciences,Institute of Brain,Behaviour and Mental Health,The University of Manchester,UK.
6
Wolfson Centre for Age-Related Diseases,Kings College London,UK.
7
Department of Primary and Community Care,Centre for Family Medicine,Geriatric Care and Public Health,Radboud University Medical Centre,Nijmegen,the NetherlandsandJoachim & Anna,center for specialized geriatric care,Nijmegen,the Netherlands.

Abstract

BACKGROUND:

To produce a practice guideline that includes a set of detailed consensus principles regarding the prescription of antipsychotics (APs) amongst people with dementia living in care homes.

METHODS:

We used a modified Delphi consensus procedure with three rounds, where we actively specified and optimized statements throughout the process, utilizing input from four focus groups, carried out in UK, Norway, and the Netherlands. This was done to identify relevant themes and a set of statement that experts agreed upon using the Research and Development/University of California at Los Angeles (RAND/UCLA) methodology.

RESULTS:

A total of 72 scientific and clinical experts and 14 consumer experts reached consensus upon 150 statements covering five themes: (1) General prescription stipulations, (2) assessments prior to prescription, (3) care and treatment plan, (4) discontinuation, and (5) long-term treatment.

CONCLUSIONS:

In this practice guideline, novel information was provided about detailed indication and thresholds of symptoms, risk factors, circumstances at which APs should be stopped or tapered, specific criteria for justifying long-term treatment, involvement of the multidisciplinary team, and family caregiver in the process of prescription. The practice guideline is based on formal consensus of clinicians and consumer experts and provides clinicians relevant practical information that is lacking in current guidelines.

KEYWORDS:

dementia; nursing homes; psychopharmacology

PMID:
26062126
PMCID:
PMC4582430
DOI:
10.1017/S1041610215000745
[Indexed for MEDLINE]
Free PMC Article

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