Reasoning, reviewing and reducing antipsychotics in care homes using technology

Gary Mitchell, Joanne Strain

Research output: Contribution to conferenceAbstractpeer-review


Sustained administration of antipsychotic medications can be associated with adverse effects including accelerated cognitive decline and over-sedation. Despite this, there is evidence to indicate that 80% of people living with dementia, who receive these medications, may not derive appropriate therapeutic effect from these medications.
Service Development:
Four Seasons Health Care (FSHC) have developed a specialist medication management application (App) which prompts review of antipsychotic medication that a person is prescribed. The ‘App’, runs on standard IPads.
The standards set within the App are that each resident must have a documented annual review of medication from the resident’s GP and a care plan that clearly indicates the rationale for prescription. If these standards are not met, a referral to the GP is created and, operating the find and fix principle that is central to the functionality of the system, the referral is tracked until it has been completed. The App records data on individual dose and uses a pre-programmed algorithm which automatically triggers an urgent review process if the dose exceeds the normal therapeutic range.
The App was operationalised in 46 care homes that provide care for 1,818 residents living with dementia throughout England, Scotland, Wales and Northern Ireland.
Through our analysis we found that 310 residents (17.05% of total sample) are currently prescribed antipsychotic medications. We also identified 27 residents where prescribed dose of medication exceeded the normal therapeutic range, 62 residents were identified where there was not a clear rationale provided for the use of the antipsychotic medication and 6 residents were identified where a review had not been completed within the previous 12 months.
The medication App has enabled our staff to detect and act on these findings. Furthermore we can report that the average time taken to resolve these issues is 2 days.
Original languageEnglish
Publication statusPublished - 21 Mar 2018
EventRCN Education Forum National Conference 2018 - Newcastle, United Kingdom
Duration: 20 Mar 201821 Mar 2018


ConferenceRCN Education Forum National Conference 2018
Country/TerritoryUnited Kingdom
Internet address


  • Dementia
  • Care Homes
  • Quality of Life
  • Older People
  • Antipsychotic Medications


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