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RedUSe: reducing antipsychotic and benzodiazepine prescribing in residential aged care facilities

Westbury, JL ORCID: 0000-0002-9932-9513, Gee, P ORCID: 0000-0002-9193-7813, Ling, T ORCID: 0000-0003-4361-5294, Brown, DT, Franks, KH ORCID: 0000-0001-8635-216X, Bindoff, I ORCID: 0000-0002-8170-8339, Bindoff, A ORCID: 0000-0002-0943-2702 and Peterson, GM ORCID: 0000-0002-6764-3882 2018 , 'RedUSe: reducing antipsychotic and benzodiazepine prescribing in residential aged care facilities' , Medical Journal of Australia, vol. 208, no. 9 , pp. 398-403 , doi: 10.5694/mja17.00857.

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Objective: To assess the impact of a multi-strategic,interdisciplinary intervention on antipsychotic andbenzodiazepine prescribing in residential aged care facilities(RACFs).Design, setting: Prospective, longitudinal intervention inAustralian RACFs, April 2014 e March 2016.Participants: 150 RACFs (with 12 157 residents) comprised themain participant group; two further groups were consultantpharmacists (staff education) and community pharmacies(prescribing data). Data for all RACF residents, excludingresidents receiving respite or end-stage palliative care, wereincluded.Intervention: A multi-strategic program comprisingpsychotropic medication audit and feedback, staff education,and interdisciplinary case review at baseline and 3 months; finalaudit at 6 months.Main outcome measure: Mean prevalence of regularantipsychotic and benzodiazepine prescribing at baseline, and at3 and 6 months. Secondary measures: chlorpromazine anddiazepam equivalent doses/day/resident; proportions ofresidents for whom drug was ceased or the dose reduced;prevalence of antidepressant and prn (as required) psychotropicprescribing (to detect any substitution practice).Results: During the 6-month intervention, the proportion ofresidents prescribed antipsychotics declined by 13% (from21.6% [95% CI, 20.4e22.9%] to 18.9% [95% CI, 17.7e20.1%]),and that of residents regularly prescribed benzodiazepines by21% (from 22.2% [95% CI, 21.0e23.5%] to 17.6% [95% CI, 16.5e18.7]; each, P P P Conclusions: The RedUSe program achieved significantreductions in the proportions of RACF residents prescribedantipsychotics and benzodiazepines.

Item Type: Article
Authors/Creators:Westbury, JL and Gee, P and Ling, T and Brown, DT and Franks, KH and Bindoff, I and Bindoff, A and Peterson, GM
Keywords: psychotropic, intervention, antipsychotics and benzodiazepines, nursing homes
Journal or Publication Title: Medical Journal of Australia
Publisher: Australasian Med Publ Co Ltd
ISSN: 0025-729X
DOI / ID Number: 10.5694/mja17.00857
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Copyright 2018 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved.

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