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Breakthrough examination Dementia patients receive too often psychotropic drugs
In many nursing homes residents in this country receive more psychotropic drugs than necessary. This shows a funded by the Federal Ministry of Health investigation whose results are included in the care report 2017 of the health insurance AOK. Accordingly, especially the home residents are affected with dementia. According to the study, 40 percent of those affected would permanently receive neuroleptics - although in most cases these drugs are not approved for the treatment of dementia.
Dementia patients are particularly affected
The AOK Nursing Report 2017 contains startling results regarding the use of medication in many German nursing homes. Accordingly, a part of the approximately 800,000 nursing home residents in this country gets too many psychotropic drugs. Dementia patients are particularly affected by the improper use of psychoactive drugs, informed the AOK-Bundesverband in a recent release.
Many dementia sufferers in nursing homes, according to a study unnecessarily psychotropic drugs. (Image: Kzenon / fotolia.com)Frequent use of neuroleptics
The results are from a study funded by the Federal Ministry of Health by the clinical pharmacologist Professor Petra Thürmann. The study showed that almost half of the 500,000 residents with dementia are treated with so-called neuroleptics. These are drugs from the group of psychotropic drugs that work against psychotic symptoms such as hallucinations and persecution anxiety and at the same time calming and depressing the nervous system.
Agents can cause serious side effects
Forty percent of residents with dementia would permanently contain at least one neuroleptic - in the elderly without dementia, however, the proportion is only 20 percent.
The problem: For the treatment of patients with dementia, the medicines also known as "antipsychotics" are for the most part not even thought, explains Petra Thürmann. You may also experience dangerous side effects such as falls, a stroke, or thrombosis.
"Only very few drugs are approved for the treatment of delusions in dementia, and then only for a short therapy duration of six weeks," said the expert, who is also a member of the Expert Council of the Federal Ministry of Health.
Thürmann had examined about 850 residents for their study on behalf of the AOK. Her conclusion is clear: "The widespread and long-term use of neuroleptics in nursing home residents with dementia violates the guidelines," she points out the situation abroad. While in this country 47 percent and in Spain even 54 percent of those with dementia would have neuroleptics, the proportion in Sweden and Finland is only 12 or 30 percent. "So there seems to be scope and alternatives," says the pharmacologist.
Caregivers confirm frequent use of psychotropic drugs
The results on dealing with psychotropic drugs in nursing homes are also in line with the statements of the nurses themselves. This is shown by a written survey of 2,500 carers by the AOK's Scientific Institute (WidO), which was also published in the new care report.
Professionals said that on average more than half of their home residents receive psychotropic drugs. In two-thirds of those affected (64 percent), therefore, the drugs were also used for more than a year. Frightening: The majority of the nurses (82 percent) considers the survey to be appropriate, the AOK reports.
Not enough time for alternative procedures
"The problem awareness of the nurses must obviously be sharpened here. In order to reduce the use of psychotropic drugs in nursing homes, it should be ensured that non-drug-based approaches are more firmly established in everyday working life. " Antje Schwinger from WidO. Thus, alternative approaches to the survey come after e.g. in the form of special care concepts or cognitive and sensory procedures, although generally more commonly used. But more than half of respondents (56 percent) said that due to time constraints, these could be partially or not fully implemented.
Responsibility lies with doctors and nursing home operators
However, from the point of view of the chairman of the board of the AOK-Bundesverband, Martin Litsch, the responsibility for the frequent unnecessary administration of psychotropic drugs lies least with the nursing staff. Instead, especially the treating physicians as well as the nursing home operators would have to ensure a guideline-compatible medicine. "Doctors have a duty to use these drugs only if there is no other option and only as short as possible," said Lychee according to the AOK release.