Antipsychotic Rx often relates to non-approved indications

18 feb 2015—For individuals with dementia living in nursing homes, the provider's rationale for use of antipsychotic drug therapy frequently relates to indications for which these drugs are not approved, according to a study published online Jan. 30 in the Journal of the American Geriatrics Society.

Alice F. Bonner, Ph.D., R.N., from Northeastern University in Boston, and colleagues conducted a qualitative, descriptive study set in 26 medium-sized and large facilities housing individuals living with dementia. The authors collected data from medical record abstraction and interviews with prescribers, administrators, direct care providers, and family members. They developed a coding scheme and coded reasons for antipsychotic prescribing.

The researchers found that among the 204 nursing home residents in the study, the major categories of reasons for antipsychotic medication use were behavioral, psychiatric, emotional states, and cognitive diagnoses or symptoms. Verbal and physical aggression were the most commonly identified behavioral reasons. Psychosis was most frequently described in the psychiatric category. The most common emotional states cited were anger and sadness.

"The rationale for use of antipsychotic drug therapy frequently relates to a wide variety of indications for which these drugs are not approved and for which evidence of efficacy is lacking," the authors write. "These findings have implications for clinical practice and policy."

More information: Abstract
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