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A 12-month follow-up study of “RedUSe”: a trial aimed at reducing antipsychotic and benzodiazepine use in nursing homes

Published online by Cambridge University Press:  24 March 2011

Juanita Westbury ,
Lisette Tichelaar ,
Gregory Peterson ,
Peter Gee  and
Shane Jackson
Juanita Westbury*
Affiliation:
Unit for Medication Outcomes, Research and Education, School of Pharmacy, University of Tasmania, Sandy Bay, Tasmania, Australia
Lisette Tichelaar
Affiliation:
Department of Pharmacotherapy and Pharmaceutical Care, Pharmacy and Pharmaceutical Science, University of Groningen, Groningen, The Netherlands
Gregory Peterson
Affiliation:
Unit for Medication Outcomes, Research and Education, School of Pharmacy, University of Tasmania, Sandy Bay, Tasmania, Australia
Peter Gee
Affiliation:
Unit for Medication Outcomes, Research and Education, School of Pharmacy, University of Tasmania, Sandy Bay, Tasmania, Australia
Shane Jackson
Affiliation:
Unit for Medication Outcomes, Research and Education, School of Pharmacy, University of Tasmania, Sandy Bay, Tasmania, Australia
*
Correspondence should be addressed to: Juanita Westbury, MSc, BPharm, University of Tasmania, Unit of Medication Outcomes Research and Education, School of Pharmacy, Locked Bag 26, Hobart, Tasmania 7001. Phone: +61 3 6226 1966; Fax: +61 3 6226 7627. Email: [email protected].
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Abstract

Background: To assess the long-term impact of the “Reducing Use of Sedatives” (RedUSe) trial on antipsychotic and benzodiazepine prevalence and dosage.

Methods: RedUSe was a six-month controlled trial conducted in 25 Tasmanian nursing homes in 2008–9 which led to significant reductions in benzodiazepine and antipsychotic use and a doubling of dose reductions of these agents. In a follow-up study, data on psychotropic use was collected from all nursing homes a year after the final RedUSe measure. Mean daily doses for each home were calculated by converting antipsychotic and benzodiazepine doses to chlorpromazine and diazepam equivalents, respectively. To determine the long-term impact of the project, 6-month and initial baseline data were compared to the 18-month follow-up data.

Results: 1578 residents were audited for the follow-up measure. In the 18 months since the RedUSe project was instigated, benzodiazepine prevalence fell by 25% in intervention nursing homes. Similarly, the mean daily diazepam equivalence in these homes had fallen by 24%. In contrast, after a significant reduction during the RedUSe trial, antipsychotic prevalence returned to baseline levels in intervention nursing homes, with mean chlorpromazine equivalence remaining relatively constant with time. There was a delayed reduction in benzodiazepine and antipsychotic use in the control homes.

Conclusions: Both benzodiazepine usage and mean daily diazepam equivalence continued to decline in intervention nursing homes in the year following the RedUSe trial. However, the effect of the RedUSe intervention on antipsychotic prevalence and dosage was not sustained.

Keywords

psychotropicaged care homesinterventionmultidisciplinary care
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 8 , October 2011 , pp. 1260 - 1269
Copyright
Copyright © International Psychogeriatric Association 2011

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