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Farm Hosp. 2019 Jul 1;43(4):140-145. doi: 10.7399/fh.11217.

Deprescribing antipsychotics in long term care patients with dementia.

Author information

1
Servicio de Farmacia, Residencia de Personas Mayores dependientes Burriana, Castellón. bravo_pat@gva.es.
2
Servicio de Farmacia, Residencia de Personas Mayores dependientes "La Cañada", Valencia. saez_carlle@gva.es.
3
Servicio de Farmacia, Residencia de Personas Mayores dependientes "La Cañada", Valencia. per_jua@gva.es.

Abstract

in English, Spanish

OBJECTIVE:

To develop a clinical protocol for the use of antipsychotic drugs in dementia patients with  behavioral disturbances that includes prescribing and deprescribing criteria and to assess its  applicability in longterm care institutions.

METHOD:

The protocol was developed from an interdisciplinary perspective based on a literature  search of the published proposals on antipsychotic drug use in dementia patients. Its applicability to  the antipsychotic deprescribing process was assessed in a single center in a prospective before-after study  with a follow-up of 6 months after the intervention study.

RESULTS:

A protocol was developed that includes prescribing and deprescribing criteria. The  intervention was performed in 35 patients (21 [60%] female). Antipsychotic treatment was  completely withdrawn in 28 patients (80%) and was reduced to the minimum effective dose in 7  (20%). Treatment was  resumed in 2 patients due to worsening symptoms. The pre- and 6-month post-test results showed that  there were no significant changes in neuropsychiatric symptoms (12.91 ± 12.80 vs 13.76 ± 16.68; P = 0.124). Conclusions: The establishment of a protocol that includes prescribing and deprescribing criteria, in  combination with the incorporation of a pharmacist in the multidisciplinary team, can be effective in  improving the use of these drugs in elderly dementia patients in long-term care institutions.

PMID:
31276444
DOI:
10.7399/fh.11217
[Indexed for MEDLINE]
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