Better training, less medications

Behaviors are often a cry for an unmet need. Deciphering the need can reduce the need for antipsychotic medications in residents with dementia, a new study suggests.

Researchers found antipsychotic use was lower when staff were trained to recognize challenging behaviors as a form of communication. Findings were published in JAMA Internal Medicine.

“This is the largest study to show that it is possible to reduce antipsychotic use in the nursing home population,” says study leader Jennifer Tija, MD, MSCE, associate professor of quantitative health science at the University of Massachusetts Medical School in a press release. “This intervention focused on treating the residents as human beings with needs, not as patients with problems. We don’t medicate babies when they cry or act out because we assume that they have a need that we need to address. However, when people with dementia are unable to communicate, the current approach medicates them when they have undesirable behaviors.”

Tija and colleagues studied the influence of the OASIS communication training program that teaches frontline nursing home staff, including nursing assistants, nurses, dietary staff and receptionists to use nonpharmacological approaches for residents with dementia. Specifically, researchers examined off-label antipsychotic use in 93 Massachusetts nursing homes that participated in OASIS from 2011 to 2013. They found the prevalence of antipsychotic prescriptions decreased 7 percent in nine months.

Researchers compared those results to 831 nursing homes in Massachusetts and New York that were not using that program, though some used a different intervention. At those facilities, the prevalence of antipsychotic drugs decreased 4 percent.

Susan Wehry, MD, developed OASIS, which was launched by the Massachusetts Senior Care Association in collaboration with the Massachusetts Department of Health. Nursing homes using OASIS need period training to successfully continue reducing the rate of anitpsychoitcs, Tija says.

Topics: Alzheimer's/Dementia