Community Pharmacy Promoting Appropriate Sedative Use in Aged Care Facilities: the ReDUSe project
|Institution:||University of Tasmania|
|Chief Investigator:||Professor Greg Peterson|
Objective: To evaluate a pharmacy-led, multi-faceted, interdisciplinary intervention to reduce the use of benzodiazepines and antipsychotics in aged care homes: the ‘RedUSe’ (Reducing Use of Sedatives) project.
Methods: ‘RedUSe’ was a controlled trial conducted in 25 Tasmanian aged care homes. A series of ‘Quality Use of Medicines’ (QUM) strategies were provided to intervention homes by community pharmacists, including two medication audit cycles, nursing staff education and interdisciplinary ‘sedative review plans’. Data on psychotropic use at each home was collected utilising a customised software application at baseline, 12 and 26 weeks.
Results: An average of 1591 residents’ medications was audited for each RedUSe measurement. Over the six month trial, there was a significant reduction in the percentage of intervention home residents regularly taking benzodiazepines (31.8% to 26.9%, p < 0.005) and antipsychotics (20.3% to 18.6%, p < 0.05), whereas control home use did not alter significantly. For residents taking benzodiazepines and antipsychotics at baseline, there were significantly more dose reductions/cessations in intervention homes than in control homes (benzodiazepines: 39.6% vs. 17.6%, p < 0.0001; antipsychotics: 36.9% vs. 20.9%, p < 0.01). Pharmacist and nursing staff participants reported a high degree of satisfaction with the project’s interventions.
Conclusion: ‘RedUSe’ led to a significant reduction in the proportion of residents in aged care homes taking benzodiazepines and antipsychotics, and a significant increase in the number of dose reductions of these agents. Our findings suggest that a multi-faceted program incorporating QUM strategies, coordinated through community pharmacy, can offer an effective approach in reducing sedative use in aged care homes.