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Explosive investigation: Dementia patients are given psychotropic drugs too often


Study reveals improper use of psychiatric drugs
In many nursing homes, residents in this country receive more psychotropic drugs than necessary. This is shown by an investigation funded by the Federal Ministry of Health, the results of which are included in the 2017 health report of the AOK health insurance company. Accordingly, the residents of the home with dementia are particularly affected. According to the study, 40 percent of those affected would receive neuroleptics on a permanent basis - although in most cases these drugs are not even approved for the treatment of dementia.

Dementia patients are particularly affected
The AOK Nursing Report 2017 contains frightening results regarding the use of medication in many German nursing homes. According to this, some of the approximately 800,000 nursing home residents in Germany receive too many psychotropic drugs. Dementia sufferers are particularly badly affected by the improper use of psychoactive drugs, the AOK-Bundesverband said in a recent announcement.

Frequent use of neuroleptics
The results come from a study sponsored by the Federal Ministry of Health of the clinical pharmacologist Professor Petra Thürmann. The study had shown that almost half of the 500,000 residents with dementia are treated with so-called neuroleptics. These are drugs from the group of psychopharmaceuticals, which act against psychotic symptoms such as hallucinations and fear of persecution and at the same time have a calming and dampening effect on the nervous system.

Agents can cause serious side effects
40 percent of residents with dementia would permanently contain at least one neuroleptic - whereas the proportion of seniors without dementia was only 20 percent.
The problem: For the treatment of dementia patients, most of the medicines, also known as “antipsychotics”, are not intended at all, explains Petra Thürmann. They could also lead to dangerous side effects such as falls, a stroke or thrombosis.

"Only very few active ingredients are approved for the treatment of delusions in dementia, and then only for a short therapy period of six weeks," said the expert, who is also a member of the Council of Experts of the Federal Ministry of Health.

On behalf of the AOK, Thürmann examined around 850 residents. Her conclusion is clear: "The broad and permanent use of neuroleptics in nursing home residents with dementia violates the guidelines," she refers to the situation abroad. While in Germany 47 percent and in Spain even 54 percent of people with dementia receive neuroleptics, the proportion in Sweden and Finland is only 12 and 30 percent, respectively. "So there seems to be scope and alternatives," emphasizes the pharmacologist.

Nurses confirm frequent use of psychotropic drugs
The results on the handling of psychotropic drugs in nursing homes also coincide with the statements of the nursing staff themselves. This is shown in a written survey of 2,500 nurses by the AOK Scientific Institute (WidO), which was also published in the new nursing report.

The specialists stated that on average, more than half of the residents of their home received psychotropic drugs. In two thirds of those affected (64 percent), the medication was used for longer than a year. Terrifying: The majority of nurses (82 percent) consider the survey to be appropriate according to the scope of the regulation, reports the AOK.

Not enough time for alternative procedures
"The problem awareness of the nursing staff obviously has to be raised here. In order to reduce the use of psychotropic drugs in nursing homes, it should be ensured that non-medicinal approaches are more firmly established in everyday work, ”says Dr. Antje Schwinger from WidO. So come alternative approaches to the survey, e.g. in the form of special care concepts or cognitive and sensory procedures generally used more often. However, more than half of the respondents (56 percent) stated that some of these could only be implemented insufficiently or not at all due to time pressure.

Responsibility lies with doctors and nursing home operators
From the perspective of the chairman of the AOK Federal Association, Martin Litsch, the responsibility for the frequent unnecessary administration of psychotropic drugs lies least with the nursing staff. Instead, the treating physicians and nursing home operators in particular would have to ensure that medicine conforms to the guidelines. "Doctors are obliged to use these drugs only when there is no other way and only as short as possible," said Litsch, according to the AOK announcement.

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