Why 'RedUSe'? Rationale for studying the clinical outcomes of sedative reduction in the residential aged care setting

Research consistently shows high usage of psycholeptic medication (predominantly antipsychotics and benzodiazepines) 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 effectiveness. Generally, antipsychotic reduction has not been shown to significantly affect BPSD; however, both deterioration and improvement in BPSD has been detected in sub-groups of residents depending on severity of baseline behaviour and initial antipsychotic dose. Furthermore, research is conflicting as to whether or not psycholeptic reduction diminishes rates of falls, and subsequent fractures. Currently, the “Reducing the Use of Sedatives” (RedUSe) project (Westbury, Jackson, Gee, & Peterson, 2010) is being expanded nationally to promote appropriate use of psycholeptics in RACFs. Clinical outcome measures, such as BPSD and falls, which have often been absent from similar implementation projects, will be monitored to observe the effect of psycholeptic reduction on residents.