Antipsychotic drugs or neuroleptics are often used to treat the behavioural and psychological symptoms of dementia (BPSD) despite an increasing evidence of potential harms associated with the use of these drugs. Nevertheless, between 20% and 50% of dementia patients are still being prescribed neuroleptics, whereas those living in nursing homes have significantly greater rates compared with those individuals living in the community.
The Therapeutic Guideline (TG) for treatment of BPSD was created by a multidiscipliary team in the region to reduce the number of neuroleptics in nursing home patients with dementia. Patients from 7 nursing homes in Arenys de Mar (Barcelona, Spain) participated in the study, where their family physician and primary care pharmacist conducted a medication review and elaborated a therapeutic plan (TP) per patient based on the guideline. The TP focused on alternatives to drugs for the management of BPSD, leading to a reduction in the prescription of neuroleptics.
The project has combined data from the nursing homes as well as collected data from external sources to populate the model with values for transition probabilities and relative risk for mortality.