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Farmacia Hospitalaria
versión On-line ISSN 2171-8695versión impresa ISSN 1130-6343
Resumen
BRAVO-JOSE, Patricia; SAEZ-LLEO, Carmen Isabel y PERIS-MARTI, Juan Francisco. Deprescribing antipsychotics in long term care patients with dementia. Farm Hosp. [online]. 2019, vol.43, n.4, pp.140-145. Epub 14-Oct-2019. ISSN 2171-8695. https://dx.doi.org/10.7399/fh.11217.
Objective
To develop a clinical protocol for the use of antipsychotic drugs in dementia patients with behavioral disturbances that includes prescribing and deprescribing criteria and to assess its applicability in long-term care institutions.
Method
The protocol was developed from an interdisciplinary perspective based on a literature search of the published proposals on antipsychotic drug use in dementia patients. Its applicability to the antipsychotic deprescribing process was assessed in a single center in a prospective before-after study with a follow-up of 6 months after the intervention study.
Results
A protocol was developed that includes prescribing and deprescribing criteria. The intervention was performed in 35 patients (21 (60%) female). Antipsychotic treatment was completely withdrawn in 28 patients (80%) and was reduced to the minimum effective dose in 7 (20%). Treatment was resumed in 2 patients due to worsening symptoms. The pre- and 6 - month post-test results showed that there were no significant changes in neuropsychiatric symptoms (12.91 ± 12.80 vs 13.76 ± 16.68; P = 0.124).
Conclusions
The establishment of a protocol that includes prescribing and deprescribing criteria, in combination with the incorporation of a pharmacist in the multidisciplinary team, can be effective in improving the use of these drugs in elderly dementia patients in long-term care institutions.
Palabras clave : Antipsychotic agents; Deprescribing; Behavioral symptoms; Alzheimer’s disease; Dementia; Nursing homes.