The risk for inadequate treatment with psychotropic medication is
higher (and these are also the reference points for prevention),
particularly if:
a)
the professional competence of the prescribing doctor is
insufficient or appropriate care by doctors with geriatric or
psychiatric training is not ensured (psychotropic medication is
prescribed by general practitioners; visits by specialists do not
take place regularly or take place too seldom);
b)
the nursing and care staff is not appropriately qualified
(in particular as far as dealing with challenging behaviour is
concerned);
c)
the cooperation between doctors, pharmacists and nursing staff
is inadequate;
d)
documentation is insufficient (if, for example, indication, the
symptoms being treated and the effectiveness of the treatment
are not documented, administration of PRN medication must be
adequately specified in order to not leave the decision about the
medication up to the nursing staff);
e)
non-pharmacological measures
consideration or none at all.
are
given
too
little
There are some positive initiatives, which were begun or expanded
after the presentation of the report of the NPM.
In 2015, Lower Austria began the “medication reconciliation” project in
collaboration with the Baden Regional Hospital, the Lower Austria
State Nursing Home Baden, the Mödling Regional Hospital, the Lower
Austria State Nursing Home Mödling, the Lower Austrian Public
Regional Health Insurance Office (NÖGKK), the Social Insurance
Institution for Trade and Industry (Sozialversicherungsanstalt der
Gewerblichen Wirtschaft) and the Health and Social Fund of Lower
Austria (NÖ Gesundheits- und Sozialfonds). The intention is to optimise
patients’ medication and to reduce the negative effects of
polypharmacy.
Lower Austria
Another project in Lower Austria is the “Lower Austrian Nursing Home
Polystudy” (“NÖ-H-Polystudie”). Within the scope of the study, the
medication of all new residents accepted in regional nursing homes is
ascertained and re-examined after eight weeks. The results will in all
likelihood be available in late 2016.
The improvement of care of patients with dementia, the increase in the
number of care and nursing staff in nursing homes, support by local
office-based doctors as well as the reduction or adjustment of
psychotropic medication is also the objectives of the project
“Gerontopsychiatry in Nursing Homes” (“Gerontopsychiatrie in
Vorarlberg
40
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