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Communication training cuts antipsychotic use in nursing homes

Training nursing home staff to understand the personhood of patients with dementia reduces off-label prescribing of antipsychotics, New England study results show.

Senior woman eating in a care home


Researchers conclude that interventions focusing on the personhood of nursing home residents, rather than prescribing antipsychotics, could reduce use of the medications in dementia patients

Antipsychotics continue to be prescribed to patients with dementia in nursing homes, despite concerns over side effects and limited efficacy.

In research published in JAMA Internal Medicine[1] (online, 17 April 2017), a team explored the effect of a training programme that encouraged nursing home staff to reframe the challenging behaviour of dementia patients as the communication of unmet needs and approach it in a non-pharmacological manner.

The researchers found that, after a three-month training phase and six-month implementation phase, antipsychotic use fell significantly in the 93 nursing homes assigned to the intervention compared with 831 nursing homes not using the programme (-22.3 versus -17.2% relative reduction).

They conclude that interventions that focus on the personhood of who nursing home residents are, rather than antipsychotic prescribing, could reduce use of these medications in dementia patients.

Citation: Clinical Pharmacist DOI: 10.1211/CP.2017.20202655

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