Antipsychotics in dementia
ALCOVE’s partners and work package leaders share the concrete goal of ensuring patient safety and improving quality of life for individuals living with Alzheimer’s disease and other dementias in Europe. An important element of this goal and the tie that binds the work being completed by all of those involved is a focus on reducing the overexposure to antipsychotic drugs among individuals living with dementia.
The overuse of antipsychotics in dementia is a shared issue in Europe and in several other countries throughout the world. The exact extent of this exposure to antipsychotics among those living with dementia is not yet sufficiently documented in all countries, but in those where such data exists, the rate ranges from 15% in the ambulatory setting to 20 to 40% in nursing homes, which is a much higher rate then in the general elderly population.
Antipsychotics are often prescribed in people living with Alzheimer’s disease and related dementia for their behavioural disorders (BPSD). These disorders are estimated to occur in 80% of patients at any given time during the course of their dementia. These drugs have recently been found to be non-effective and deleterious for these patients as they can lead to falls, excessive sedation, stroke and an increased risk of mortality, with an overall profoundly negative impact on the individual’s health, ability to communicate and quality of life.
In order to improve care for people experiencing behavioural disorders and to reduce the use of antipsychotics, ALCOVE will:
- Make a statement on the risk exposure related to antipsychotic use in people living with dementia in Europe.
- Propose indicators and methods to better measure and identify these situations at risk.
- Identify the existing support systems for people exhibiting BPSD, specifically focusing on innovative and/or efficient measures in limiting the prescription of antipsychotics.
- Analyze the current education that health care personnel (and carers) receive in working with patients exhibiting BPSD and find areas where this education could be enriched.
- Collect the procedures in place for the prescribing of antipsychotics (the majority have an off- label use) in clinical practice in European countries.
- Analyse the consideration that is given to whether an individual living with dementia has been prescribed antipsychotics or not when a competence assessment is performed.
- Map and analyse the dedicated prevention strategies at the national-level developed by some European countries on this topic.
ALCOVE aims to better quantify the risk of exposure related to antipsychotic use in people living with dementia, to capitalize on existing European knowledge and best practices, systems and dedicated programmes to prevent this exposure, and subsequently to use this data to promote assessed strategies and tools to reduce the risks related to antipsychotics and their consequences on the health and quality of life of patients and their carers.
By promoting the best options in Alzheimer’s disease care and providing a toolbox of care options, ALCOVE will help European Member States reduce the risks involved in the use of antipsychotic medications to treat BPSD, promote alternative treatments, and alert and educate carers so that they will be better equipped and more supported when caring for individuals living with Alzheimer’s disease and other related dementia.