Lynch: Oversight needed on use of psychotropic drugs

Stronger oversight over the prescription of powerful psychotropic drugs for vulnerable patients is needed, Minister of State Kathleen Lynch has said.

Ms Lynch was responding to Irish Times articles this week highlighting the scale of anti- psychotic drug use in nursing homes and disability centres.

“I have serious concerns over these issues,” she said. “If a person with difficult behaviour is being chemically controlled or restrained, what kind of quality of life does that person have, especially where there are other ways of addressing these issues?”

She said community pharmacists should play a key role in reducing unnecessary prescriptions and addressing the overuse of drugs among people with dementia living in care homes.

Campaigns

She said awareness campaigns aimed at doctors, nurses and care staff may be needed to help ensure there is a new focus on appropriate drug use.

The precise scope of the Health Information and Quality Authority may also need to be reviewed to ensure it is in a position to monitor the quality of care in long-stay settings.

Health authorities, meanwhile, are to develop new guidelines on the use of powerful psychotropic.

Under UK guidelines, these so-called “chemical cosh” drugs should be used as a last resort on older patients and those with dementia when behaviour poses a risk of harm.

This is because research shows the medication can double the risk of death and treble the risk of stroke for vulnerable patients.

In a statement to this newspaper, the HSE said new guidance material is being prepared on the management of drugs for people with dementia.

All residential services should have a policy on the use of psychotropic medication for older people to inform best practice, it said.

In addition, all residents with challenging behaviour issues will be obliged to have care plans in the event of such behaviour occurring.

These will be assessed and reviewed at regular intervals .

The developments form part of the national dementia strategy, aimed at boosting care standards for older people in need of 24-hour nursing care.

Clinical records

A number of studies, along with clinical records, indicate that anything up to one in three residents in many nursing homes are being prescribed psychotropic drugs.

The Alzheimer's Society of Ireland yesterday welcomed new rules over the use of medication.

“Dementia is a complex condition and where medication is being prescribed it is crucial that it is done so appropriately,” said Tina Leonard, head of advocacy and public affairs.

She said underlying causes – such as pain, frustration or confusions – should be investigated first and anti-psychotic medication should be a last resort.

Latest research shows that more than half of people with learning disabilities living in residential centres are being administered anti-psychotics.

Paddy Connolly of Inclusion Ireland, the umbrella group or people with intellectual disabilities, said safeguards for people with disabilities living in care centres are also needed.