Tackling the inappropriate use of psycho-active medication in Scotland

Creating Better Dementia Care ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Psycho-active Medication? ,[object Object],[object Object],[object Object],[object Object],[object Object]

Strategy Commitments ,[object Object],[object Object],[object Object]

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What did we do? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

What did we show? ,[object Object]

1 st message ,[object Object]

2 nd message ,[object Object],[object Object]

3 rd key message ,[object Object],[object Object]

4 th key message ,[object Object],[object Object]

What we cannot tell from this study ,[object Object],[object Object],[object Object]

Who starts the medication? ,[object Object],[object Object],[object Object]

NHS Fife Old Age Psychiatry Withdrawal of Antipsychotics in patients with Dementia Quick Reference Guide Patient with Dementia on Antipsychotic Medication for >12 weeks History of severe agitation, aggression, psychosis prior to prescription Yes Seek psychiatric advice from local team who will base decision making on current SIGN/NICE guidance Other drugs Reduce by approximately 20% of the dosage every 2 weeks Quetiapine >150mgs/day Reduce by 50mgs every 2 weeks to a dose of 100mgs Quetiapine= 100mgs/day Reduce by 25mgs every 2 weeks until stopped Olanzapine >5mgs/day Reduce by 2.5mgs every 2 weeks to a dose of 5mgs Olanzapine = 5mgs/day Reduce to 2.5mg for 4 weeks and stop. Risperidone >2mgs/day Reduce by 0.5mgs every 2 weeks to a dose of 1mg Risperidone = 1mg/day Reduce to 0.5mg for 4 weeks and stop. Haloperidol >2mgs /day Reduce by 0.5mgs every 2 weeks to a dose of 1mg Haloperidol = 1mg Reduce to 0.5mg for 4 weeks and stop. Assess after 1 month to rule out Depression/anxiety/return of symptoms. Discuss with local Old Age Psychiatry team if symptoms recur ,[object Object],[object Object],Dr Stella Clark, On behalf of the Old Age Psychiatrists March 2011 No GP led reduction in medication

Is prescribing is influenced by where people are living? ,[object Object],[object Object]

Health Informatics Centre ,[object Object],[object Object],[object Object],[object Object]

What did we do? ,[object Object],[object Object],[object Object]

1st message ,[object Object],[object Object]

2nd key message ,[object Object],[object Object],[object Object],[object Object]

Implications ,[object Object],[object Object]

Forth Valley Care Home Liaison Service ,[object Object],[object Object],[object Object]

Summary ,[object Object],[object Object],[object Object]

Tackling the inappropriate use of psycho-active medication in Scotland

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Tackling the inappropriate use of psycho-active medication in Scotland