Person-centered, non-drug approaches cut LTC antipsychotic use by 75%

A non-pharmacological, person-centered treatment plan helped eliminate regular antipsychotic medication use in 75% of study participants, while still effectively treating behavioral and psychological symptoms of dementia, a new study by Australian researchers has found.

A total of 132 long-term care residents who regularly used the medications were recruited by researchers from the University of New South Wales to take part in study. Each resident received two assessments to create protocols for gradual reductions in antipsychotic dose based on each individual's neuropsychiatric symptoms. Nurses were trained to manage the symptoms through the use of person-centered, non-pharmacological approaches to compensate for the reductions.

“There is broad consensus that using antipsychotics to treat dementia symptoms should be a last resort,” said Beth Kallmyer, MSW, Alzheimer's Association vice president of constituent services. “Unfortunately, we still see a systematic use of these drugs in residential care facilities in the United States and around the world.”

The dosages were incrementally decreased over a course of the study and patients received the alternative treatment. Each individual was re-evaluated at three months, six months and 12 months after the initial reduction. Results were compared to the previous assessments.

By the conclusion of the study, 121 of the 132 participants no longer used antipsychotics and three-fourths remained off the medication for up to six months. Study results were announced Monday at the Alzheimer's Association International Conference in Toronto.

“Results from the project presented today show there are more effective and appropriate alternatives to managing BPSD, and with well-designed programs to reduce use of antipsychotic medications, cultural barriers can be successfully overcome. We urge prescribers in the U.S. to assess results of this program and understand how they too can continue to work towards more person-centered, non-pharmacological approaches to manage these symptoms,” Kallmyer said.