The impact of reducing sedatives on residents: the rationale for translating sedative reduction into clinical outcomes

BACKGROUND
Psycholeptic (predominantly antipsychotics and benzodiazepines) usage is high in many residential
aged care facilities (RACFs). Antipsychotics are often employed to treat behavioural and
psychological symptoms of dementia (BPSD) while benzodiazepines are frequently used to alleviate
anxiety and sleep disturbances, despite the risk of severe adverse effects and limited efficacy.
Antipsychotic reduction has not been shown to worsen or improve BPSD except in sub-groups of
residents depending on baseline BPSD severity. Furthermore, research is conflicting as to whether or
not psycholeptic reduction diminishes the rates of falls.
AIM
This research aims to observe the impact of psycholeptic reduction on resident clinical outcomes
within a multi-strategic project.
METHODS
Currently, a multi-strategic intervention involving auditing, education and review, called the
“Reducing the Use of Sedatives” (RedUSe) project, is being expanded nationally to promote
appropriate use of psycholeptics in RACFs. While previous interventions have shown success in
reducing psycholeptic use in RACFs, few have evaluated the impact on resident clinical outcomes.
Changes in BPSD will be monitored through psychometric testing including the Neuropsychiatric
Inventory-Nursing Home Version. Baseline measurements will be taken prior to the start of the
RedUSe project and repeated after four months. Behaviour and falls rates will be monitored monthly
from baseline by a champion nurse at each RACF.
RESULTS/DISCUSSION
Data collection will take place between November 2014 and January 2016. Translating the impact
psycholeptic reduction has on resident clinical outcomes within a multi-strategic project is predicted
to be of high importance to both the government and research community at large