The health professional experience of using antipsychotic medication for dementia in care homes: A study using grounded theory and focussing on inappropriate prescribing

Abstract

Positive perceptions based on past experiences with antipsychotics should be challenged through future interventions that tackle inappropriate prescribing, for example using behaviour change techniques to better highlight adverse consequences of prescribing.

Current Psychotropic Medication Use and Contributing Factors Among Nursing Home Residents With Cognitive Impairment

“…With regard to LPN staffing our findings are in contrast to prior research which showed that when there was more LPN staffing there was greater use of psychotropic medications (Lucas et al, 2014). We anticipate that these differences are due to beliefs of the staff member rather than his or her degree or qualifications (Almutairi et al, 2018; Kerns et al, 2018).…”

“…Overall, the proposed models in this study explained very little of the variance in psychotropic medication use or in the use of opiates. Additional factors that should be considered in future research are beliefs of the staff, access to behavioral health providers, the use of person centered behavioral interventions, activities provided, length of stay of the resident, and timing of medication initiation (Almutairi et al, 2018; Atramont et al, 2018; Helvik et al, 2017; Janus et al, 2018; Kerns et al, 2018; MacLagan et al, 2017; Zhang, Letuchy, & Carnahan, 2018).…”

“…In addition age, race, and gender are associated with drug use such that those who are older, male, and African American are less likely to be on any psychotropic medication (Coleman et al, 2016; Norris et al, 2011; Punekar, Short, & Moran, 2012; Richter, Mann, Meyer, Haastert, & Köpke, 2012; Schäfers et al, 2014; Törmälehto et al, 2017). At the facility level, the beliefs of staff, prescribers, families, the culture around medication use within the facility, poor transitional care practices (Almutairi, Masters, & Donyai, 2018; Gilmore-Bykovskyi, Roberts, King, Kennelty & Kind, 2017; Kerns, Winter, & Winter, 2018; King et al, 2013; Lucas & Bowblis, 2017; van der Spek et al, 2018), access to psychiatric consultants (Cioltan et al, 2017), having dementia-specific care units within a facility (Cioltan et al, 2017; Mansbach, Mace, Clark, Firth, & Breeden, 2016), low registered nurse (RN) staffing (Hughes, Lapane, & Mor, 2000; Kim & Whall, 2006; Lucas et al, 2014; Miller, Papandonatos, Fennell, & Mor, 2006), and independent ownership (Cioltan et al, 2017; Mansbach et al, 2016) are all associated with psychotropic medication use.…”

Adherence to adjuvant endocrine therapy among breast cancer survivors: a systematic review and meta-synthesis of the qualitative literature using grounded theory

“…Despite publications covering the topic generally [ 18 , 19 ], on closer scrutiny, no guidance detailed how to undertake a GT synthesis of data using existing publications as the data source. The authors therefore shaped their own methodology, drawing heavily on the work of Atkins et al (2008) [ 20 ] for the data extraction elements and using previous GT expertise for the detailed data analysis [ 21 , 22 ].…”

Educating Nursing Home Staff in Dementia Sensitive Communication: Impact on Antipsychotic Medication Use

“…10 Administering an APM is often viewed as an easier solution to control behaviors when staff are faced with time restraints, minimal knowledge on behavioral approaches, and the perception that APMs are efficacious and low-risk. 11–13…”