We need to do better: most people with dementia living in aged care facilities use antipsychotics for too long, for off-label indications and without documented consent

摘要

Despite limited evidence for efficacy and clear evidence for harm, use of antipsychotics to manage behaviors and psychological symptoms of dementia (BPSD) is common. Australian estimates suggest that in the community setting the prevalence of use of antipsychotics is about 2 to 3% (Halfdanarson, 2017) and in the aged care setting it ranges from 13 to 42% (Westaway et aL, 2018), with at least half of the residents in aged care using antipsychotics for longer than 6 months (Kalisch et al, 2019). Prevalence of use is higher in the aged care setting because approximately 50% of aged care residents have a diagnosis of dementia, compared to a prevalence of around 10% in all Australians aged 65 years or over (Brown et al., 2017).