TY - ABST

T1 - Deprescribing antidepressants for institutionalized older persons with dementia

AU - Hølmkjær, Pernille

PY - 2023/6/9

Y1 - 2023/6/9

N2 - Background: There is a high use of antidepressants among institutionalized older persons with dementia. According to the latest guidelines it is suggested to deprescribe antidepressants. General practitioners (GPs) typically encounter multiple barriers when attempting to deprescribe antidepressants. Questions: The aim is to reduce the use of antidepressants in institutionalized older persons with dementia without increasing morbidity or mortality. Secondary outcomes include a difference in the use of other psychotropic medication, mortality, morbidity, and severity of BPSD. Method: The study is a cluster-randomized controlled trial based in general practices in Denmark. Randomization was 1:1 to intervention and control group. In total 20 practices that recruited up to 15 patients with dementia living in nursing homes is included. The intervention includes two tailored components; 1) a cased-based training course including teaching material to be used by the GP to educate nursing home staff on BPSD, 2) a dialog tool including a symptom assessment scale to be used in a structured consultation at the nursing home to encourage deprescribing of antidepressants. The control group recieves enhanced care as usual. Outcomes: We anticipate that the intervention will reduce the use of antidepressants through strengthening communication between GPs, nursing home staff and patients/relatives. Discussion: Research on this population is scarce and it is difficult to do. Many barriers exists and we will look further into this in a process evaluation which will also assess the implementability.Take home message for practice: This study will aid in the difficult task in deprescribing for a vulnerable population

AB - Background: There is a high use of antidepressants among institutionalized older persons with dementia. According to the latest guidelines it is suggested to deprescribe antidepressants. General practitioners (GPs) typically encounter multiple barriers when attempting to deprescribe antidepressants. Questions: The aim is to reduce the use of antidepressants in institutionalized older persons with dementia without increasing morbidity or mortality. Secondary outcomes include a difference in the use of other psychotropic medication, mortality, morbidity, and severity of BPSD. Method: The study is a cluster-randomized controlled trial based in general practices in Denmark. Randomization was 1:1 to intervention and control group. In total 20 practices that recruited up to 15 patients with dementia living in nursing homes is included. The intervention includes two tailored components; 1) a cased-based training course including teaching material to be used by the GP to educate nursing home staff on BPSD, 2) a dialog tool including a symptom assessment scale to be used in a structured consultation at the nursing home to encourage deprescribing of antidepressants. The control group recieves enhanced care as usual. Outcomes: We anticipate that the intervention will reduce the use of antidepressants through strengthening communication between GPs, nursing home staff and patients/relatives. Discussion: Research on this population is scarce and it is difficult to do. Many barriers exists and we will look further into this in a process evaluation which will also assess the implementability.Take home message for practice: This study will aid in the difficult task in deprescribing for a vulnerable population

M3 - Konferenceabstrakt til konference

Y2 - 7 June 2023 through 10 June 2023

ER -