How effective are psychosocial interventions for reducing the prescribing of antipsychotic medications in residential care homes?
The review was based on a small number of heterogeneous studies with important methodological shortcomings, and 3 of the 4 included studies were published in the 1990s. However, the most recent and methodologically most rigorous study showed the most pronounced effect. Follow-up periods were different between studies, ranging from 5 to 13 months (mean = 9 months). Reporting of adverse effects was insufficient. Costs of interventions were not reported in any of the studies, preventing any assumptions about cost comparison or cost- effectiveness.
In residential care homes, antipsychotic medication is commonly prescribed to control so-called "behavioural and psychological symptoms of dementia" such as agitation, aggression or restlessness. However, it is questionable whether antipsychotic medication is effective and safe. Adverse effects, such as sedation, falls, and cardiovascular symptoms, are frequent. Therefore, antipsychotic medication should be avoided if possible.