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Gériatrie et Psychologie Neuropsychiatrie du Vieillissement

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Impact of an awareness of the doctors treating on the decrease of the prescriptions of antipsychotics in the demented residents in Ehpad Volume 16, issue 4, Décembre 2018

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Authors
1 Département universitaire de médecine générale, Aix-Marseille-Université, Marseille, France
2 Service de médecine interne et gériatrie, Hôpital Nord, Assistance Publique des Hôpitaux de Marseille, AP-HM, Marseille, France
3 Service de pharmacologie clinique et pharmacovigilance, Assistance Publique des Hôpitaux de Marseille, AP-HM, France
4 Institut des neurosciences Timone, CNRS-UMR 7289, Aix-Marseille-Université, Marseille, France
5 Ehpad Korian Périer, Marseille, Marseille, France
6 Ehpad La Bastide des Oliviers, Vitrolles, Marseille, France
7 COS Saint Maur, Marseille, France
8 Médecine interne et gériatrie, Hôpitaux Sud, Assistance Publique des Hôpitaux de Marseille, AP-HM, Marseille, France
* Tirés à part

Background: Despite the context of several national warnings, antipsychotics drugs are commonly used to treat behavioural and psychological symptoms in dementia (BPSD). Aim: To observe a decrease of antipsychotic drug prescription, in old NH (nursing homes) residents with dementia, after an awareness of their general practitioner. Methods: Observational, prospective, multicenter study. The study population corresponds to NH residents with dementia, and antipsychotic drug consumption, in nursing homes volunteered to participate. Awareness-raising is carried out through information documents. The evaluation criteria is the proportion of residents under antipsychotics after sensitization. Results: out of the 30 nursing homes included, 26.7% of the patients were prescribed at least one antipsychotic and 15% were both demented and under antipsychotics. A total of 317 residents with dementia and antipsychotics were included 15% of the total NH population. Psychotropic drug co-prescriptions was very frequent 43.2% also used benzodiazepines, 37.2% anxiolytics and 33.1% antidepressants. Agitation, aggressiveness, opposition to care and wandering were the most commonly BPSD encountered. After a first sensitization, we obtained a 15.5% decrease of antipsychotic prescriptions. Conclusion: A personalized sensitization towards GP allowed a reduction of antipsychotic drugs prescription in NH residents with dementia and BPSD.