An effective approach to reduce antipsychotic and benzodiazepine use in aged care homes: the RedUSe project

The majority of residents of aged care homes have mental health conditions, including challenging behaviours of dementia, anxiety and sleep disturbance. Although non-drug strategies are recommended, medications such as antipsychotics and benzodiazepines are commonly used to manage these conditions, and residents often remain on sedative medications for extended periods despite limited effectiveness and significant side effects. The aim of the ‘RedUSe’ (Reducing Use of Sedatives) project was to evaluate a multi-faceted, interdisciplinary intervention to reduce the use of antipsychotics and benzodiazepines in aged care homes. The RedUSe project was a controlled trial conducted in 25 aged care homes in Tasmania. A series of pharmacist-led strategies were provided to intervention homes, including medication audit cycles, staff education and interdisciplinary review. Data on medication use was collected at baseline, 12 weeks and 26 weeks, with approximately 1600 residents audited for each measurement. Over the six-month trial, there was a significant reduction in the percentage of intervention home residents regularly taking benzodiazepines (31.8% to 26.9%, p < 0.005) and antipsychotics (20.3% to 18.6%, p < 0.05), whereas control home use increased slightly. There were also significantly more dose reductions/cessations in intervention homes than in control homes (benzodiazepines: 39.6% vs 17.6%, p < 0.0001; antipsychotics: 36.9% vs 20.9%, p < 0.01). Our findings suggest that strategies coordinated through community pharmacies, and incorporating the dissemination of local data on medication use, offer an effective approach to reduce sedative use in aged care homes.