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Long Term Care Medicine-2010


B38 - Less is More: An Interdisciplinary Team Approach to Appropriate Use of Antipsychotic Medications in Institutionalized Patients with Psychosis Secondary to Dementia


Mar 12, 2010 11:00am ‐ Mar 12, 2010 12:00pm

Standard: $24.00

Description

Accreditation
The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement:
The American Medical Directors Association designates
this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)™.
Physicians should only claim credit commensurate with the extent of their participation in the activity.

AMDCP Credit Designation:
This session has been approved for a total of 1 Management credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).

Session Description:
This session will highlight an IDT methodology for appropriate indications, monitoring, tapering and discontinuation of atypical and typical antipsychotic in nursing homes. The methodology will show how to substitute antipsychotic medications with IDT approach to manage adverse behaviors. In essence, this approach will substitute inappropriate and unnecessary use of antipsychotic medications with non-pharmacologic alternatives.

Learning Objectives(s):

  • Discuss the effectiveness of using an interdisciplinary team approach to reduce the use of antipsychotic medications in psychosis of dementia in institutionalized residents.
  • Explain the importance of monitoring the patients (physical exam, biochemistry and EKG) for the side effects of antipsychotic medications' and to discontinue the drugs when risks exceed benefits.
  • Describe the leadership role played by medical directors in integrating data from each of the disciplines for appropriate use of antipsychotics in Nursing Homes.
  • Discuss the role of Medical Directors in educating the interdisciplinary team.
  • Examine the beneifits of decreasing the use of antipsychotic medications in institutionalized elderly nursing home residents.


Speakers(s):
Louis Mudannayake, MD

Disclosure(s):
Louis Mudannayake, MD has no disclosures to report.

References:
1. Becky A. Briesacher, Phd, M. Rhona Limcangco, Phd, The Quality of Antipsychotic Drug Prescribing in Nursing Homes, Arc Intern Med. 2005: 165:1280-1285. 2. Lon S. Schnieder, M.D, Pierre N. Tariot, M.D, Effectiveness of Atypical Antipsychotic Drugs in Patients with Alzheimer's Disease. The New England Journal of Medicine. Oct 12, 2006. Vol 355, No. 15, 1525-1538. 3. Nursing Homes Struggle to Kick Drug Habit, The Wall Street Journal., December 20, 2007. 4. Prescription abuse seen in US Nursing Homes. Dec 04, 2007 . Wall Street Journal. 5. Parvin Kamble, Antipsychotic drug use among elderly nursing home residents in the United States. The American Journal of Geriatric Pharmacology, vol. 6, October 2008. 6. Salzman C, Jeste DV, Elderly patients with dementia-related symptoms of severe agitation and aggression: consensus statement on treatment options, clinical trials methodology and policy, J Clinical Psychiatry. June 2008 7. Hiroshi Ihara, Ethical dilemma associated with the off-label use of antipsychotic drugs for the treatment of behavioral and psychological symptoms of dementia, Psychogeriatrics, the official journal of the Japanese Psycho-Geriatric Society. 8. Clive G Ballard, Atypical antipsychotics for aggression and psychosis in Alzheimer's Disease, Cochrane Database of systematic reviews, 2009. 9. Wayne A. Ray , Atypical Antipsychotic drugs and Risk of Sudden Cardiac Death. The New England Journal of Medicine. vol. 360, Jan 15, 2009. 10. Daiello L, Atypical antipsychotics for the treatment of dementia-related behavior, Med Health R I . 2007. 11. Passmore , Michael J, Alternative to Atypical Antipsychotics for the Management of Dementia;Related Agitation, Drugs and Aging, vol. 25, 2008. 12. Soko Setoguchi, MD, DrPH, Potential Causes of Higher Mortality in Elderly Users of Conventional and Atypical Antipsychotic Medications. Journal of the American Geriatrics Society. Vol 56 Issue 9, Pages

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