Antipsychotics overprescribed in aged care

Medical care in residential facilities needs to be improved, and the use of antipsychotics in aged-care residents reduced, according to the Australian and New Zealand Society for Geriatric Medicine (ANZSGM).

A recent Four Corners investigation highlighted some of the problems experienced by aged-care residents when medicines were inappropriately prescribed, including dementia. Associate Professor Edward Strivens, President of the ANZSGM, said the general rules of medicine still apply in residential aged-care facilities — medicines should only be used to treat medically diagnosed conditions in line with professional guidelines.

“There is a high level of unnecessary use of psychotropic medicines, which include antipsychotics, to manage people with dementia,” he explained. “These medicines are effective when used in the appropriate person but research shows that more than 80% of aged-care residents with dementia receive psychotropics, even though only 20% might benefit from them.

“Medicines should be assessed regularly by qualified healthcare professionals to help with early detection and management of potential side effects and interactions.”

Older people are also more likely to use multiple medicines, making prescribing medicines for them highly complex. Geriatricians are trained to navigate this complexity, working alongside other healthcare professionals such as nurses and GPs to weigh the benefits and risks of each medicine. Medical conditions, including cognitive decline, are the main reasons for older people moving into aged-care facilities.

“There are numerous examples where the physical and mental decline of an older person is caused by an unrecognised underlying medical condition that can be treated or even reversed, if managed well.” he added. “This means improved access to the right healthcare professional at the right time is critical to better managing the complex health needs of aged-care residents.”

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