How Health PEI is weaning dementia patients off antipsychotics

A new study aimed at getting dementia patients in long-term care off antipsychotic medications has had impressive results, says Health PEI.

The study was done in conjunction with the Canadian Foundation for Healthcare Improvement and the Newfoundland and Labrador government.

It identified patients who did not have a diagnosis of psychosis but were prescribed antipsychotic medications, and who could be good candidates for coming off those medications.

"Antipsychotics have often been prescribed for individuals who may have agitated behaviour or sometimes aggression," said foundation CEO Jennifer Zelmer.

"But there's really not a lot of evidence to support their effectiveness for people who don't have a diagnosis of psychosis, and there are significant side effects. So that's why a medication review can be really helpful."

Those side effects can include confusion, dizziness and, in rare cases, stroke.

Mark Lennihan/Associated Press

In the P.E.I. portion of the study, 25 per cent of patients had their antipsychotic medication discontinued, and another 28 per cent had doses reduced.

The medication reduction was combined with offerings of individually-tailored activities, such as exercise and pet or music therapy.

Supplied/Vancouver Airport Authority

There was no change in aggressive verbal or physical behaviours among those patients.

Andrew MacDougall, the director of long-term care for Health PEI, said the study has prompted changes.

"We are moving beyond now, the project phase. It's becoming what we do on a day-to-day approach, a routine approach," said MacDougall.

The study was conducted at the province's nine publicly-funded long-term care homes. MacDougall said the province is talking to private providers about changing practices at those homes as well.

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