Although antipsychotics have the best evidence base for efficacy amongst pharmacological management of behavioral disturbances in dementia that interfere with necessary care or compromise quality of life, antipsychotics have multiple troubling side-effects including excess mortality. Regulatory pressure and societal pressure are additional factors that are contributing to a desire to minimize the use of antipsychotics. This program will present the tools necessary for implementing a successful antipsychotic reduction program. Non-pharmacological interventions are the mainstay of therapy, and a strategy of staff and family education, along with a willingness to try multiple non-pharmacological approaches in an attempt to personalize therapy, are the foundation of a successful antipsychotic reduction program. Alternative pharmacological strategies will be reviewed, but the emphasis will not be in replacing antipsychotics with other off-label treatments, but rather the emphasis will be to consider drug therapy a temporary intervention to be used as a last resort, with medications chosen to minimize the chance that there will be harm to the patient.
Learning Objectives: The overall goal of this activity is to enhance participants’ knowledge and competency in managing and treating patients with behavioral and psychological symptoms by reviewing available management strategies that will assist with minimizing the use of antipsychotics.
Upon completion of this activity, participants should be able to -
Review the evidence for efficacy of non-pharmacological management of BPSD
Compare the data for efficacy of antipsychotics with the evidence for harm to allow an appropriate risk benefit analysis
Explore the alternatives to antipsychotics for BPSD management, again comparing efficacy data with harm.
Identify strategies to implement a program to reduce reliance on antipsychotic drugs in LTC
Identify barriers to successful antipsychotic reduction.