Reasons to prescribe antipsychotics for the behavioral symptoms of XXXX : a survey in Dutch nursing homes among physicians, nurses, and family caregivers.

@entity1 @entity304 @entity146 @entity303 @entity73
OBJECTIVES: Despite serious safety concerns, prescription rates of antipsychotics for the treatment of the behavioral and psychological symptoms of @entity303 remain high, especially in nursing homes. This high prevalence of antipsychotic use cannot be explained by the modest success rate reported in the literature. In this study, we aim at clarifying the reasons for prescribing an antipsychotic drug in behavioral and psychological symptoms of @entity303 and look at the role of nurses and family caregivers in the decision-making process that precedes the prescription of an antipsychotic drug. DESIGN: Questionnaire used in a one-on-one interview with elderly care physicians, nurses, and family caregivers. SETTING: We conducted a survey in 23 nursing homes in the Netherlands. METHOD: On each @entity303 ward, the physician selected 1 or 2 @entity1 who started antipsychotics most recently. An interviewer then held a structured questionnaire with the physician, the nurse, and the first relative of the @entity1 . The first part of the interview consisted of questions about the general ideas of the physicians and the second part consisted of case-related questions to physicians, nurses, and family caregivers. RESULTS: Physicians, nurses, and family caregivers generally consider the possible benefits of antipsychotics to outweigh the risk of side effects. The main reasons to start therapy are agitation and @entity146 . Physicians felt pressured by nurses to prescribe in 17% of cases. Physicians felt supported by the guideline of the Dutch Association of Elderly Care Physicians. The estimated average success rate in the discussed cases (the @entity1 is expected to improve on the @entity146 ) among physicians was 50%, nurses reported 53%, and relatives 55%. The most frequently expected adverse reactions were increased fall risk, sedation, and @entity304 . Nurses expected @entity73 . The family felt insufficiently informed about the side effects in 44% of the cases. CONCLUSION: The interviewed nursing home physicians and nurses expect almost half of their @entity1 with @entity303 and @entity146 to benefit from antipsychotic therapy. Serious side effects were expected to occur only sporadically. These expectations may contribute to the high rate of antipsychotic use among these @entity1 .
