New standard aims to curb inappropriate use of psychotropic medicines

The Australian Commission on Safety and Quality in Health Care has released a new clinical care standard to promote the responsible and appropriate use of psychotropic medicines for people with cognitive disability or impairment.

The Psychotropic Medicines in Cognitive Disability or Impairment Clinical Care Standard provides clear guidelines to ensure safer and more effective treatment practices.

Over the past three decades, there has been a significant increase in psychotropic medicine prescriptions in Australia. While these medicines play an important role in treating mental health conditions, they are also commonly used to manage behaviours of concern experienced by people with a cognitive disability or impairment. However, there is a lack of evidence that they are effective for managing these behaviours, which may include aggression, agitation and sometimes self-harm.

The Standard aims to curb the inappropriate use of psychotropic medicines and promote patient safety. It highlights the importance of non-medication interventions as the primary method for addressing behaviours of concern, with psychotropic medicines reserved as a last resort option when other strategies have failed, or there is a high risk of harm to the person or others.

The Royal Commission into Aged Care Quality and Safety and the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability revealed concerning trends in psychotropic medicines misuse and overuse in the aged care and disability sectors. The Standard is a recognition of the rights of people with cognitive impairment to safe and effective treatment options.

Clinicians and prescribers are encouraged to be mindful of the way they use psychotropic medicines due to their risks and limited benefits for people with behaviours of concern. It is essential to have clear objectives and ways to measure the impact of these medicines, including by collaborating with behaviour support practitioners.

Monitoring and evaluating prescribing practices

Clinicians and doctors should regularly review medicines to ensure their effectiveness and be mindful of potential side effects. They should always consider whether the medicine dose can be reduced or if non-medicine approaches can improve the symptoms.

When people with intellectual disability or impairment receive care in different settings, effective communication during transitions of care and support for decision-making processes is essential to upholding patient autonomy and safety. The Standard applies to all healthcare services provided to people of all ages with cognitive disability or impairment and is relevant in any setting where they receive care, including hospitals, aged care facilities and the community.

The Older Persons Advocacy Network (OPAN) strongly supports the new clinical care standard, emphasising the importance of regularly reviewing medications and discussing the risks and benefits involved with older people, their families and carers. Older people’s right to have control over their care and to be informed about their care in a way they understand is embedded in the Charter of Aged Care Rights.

Ritchelle Drilon

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Ritchelle is a Content Producer for Healthcare Channel, Australia’s premier resource of information for healthcare.

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