Background: Neuropsychiatric symptoms of dementia are often treated through the
prescription of one or more psychotropic medications. However, limited efficacy and potential harmful
side-effects has resulted in efforts to reduce the use of psychotropic medication in this population,
particularly for those living in long-term care.
Objectives: This study sought to describe the pattern of central nervous system medication usage in older
adults with dementia living in long-term care; assess the appropriateness of prescribing against Beers
criteria; and detect potential drug interactions from co-administered medications.
Methods: A retrospective descriptive audit of the medical records of n=415 residents, aged >60 years
with a diagnosis of dementia, from 28 long-term care facilities in Queensland, Australia. Information
extracted included the types and usage of regular and Pro Re Nata central nervous system medications.
Results: Of those taking medication (n=317), 68% were prescribed at least one potentially inappropriate
medication, and there was a significant positive correlation between the number of medications
prescribed and the number of potentially inappropriate medications. Two-hundred potential interactions
with variable severity were identified from 130 residents on ≥ 1 medication – 38% were potentially
severe interactions, 46% were moderate.
Conclusion: This medication audit raises concerns that prescription of medications may still be the first
resort to treat behavioural and psychological symptoms of dementia. There is a need for effective and
sustainable person-centred interventions that address barriers for appropriate prescribing practice, and
involve the collaboration of all healthcare professionals to optimise prescribing and improve the quality
of medicines in older people with dementia.