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    Knowledge of and perceived need for evidence-based education about antipsychotic medications among nursing home leadership and staff

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    Authors
    Lemay, Celeste A.
    Mazor, Kathleen M.
    Field, Terry S.
    Donovan, Jennifer L.
    Kanaan, Abir O.
    Briesacher, Becky A.
    Foy, Sarah
    Harrold, Leslie R.
    Gurwitz, Jerry H.
    Tjia, Jennifer
    UMass Chan Affiliations
    Department of Medicine, Division of Geriatric Medicine
    Meyers Primary Care Institute
    Document Type
    Journal Article
    Publication Date
    2013-12-01
    Keywords
    Atypical antipsychotics
    evidenced-based prescribing
    nursing homes
    Geriatrics
    Health Services Research
    Medical Education
    Mental Disorders
    Pharmacy and Pharmaceutical Sciences
    Primary Care
    
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    http://dx.doi.org/10.1016/j.jamda.2013.08.009
    Abstract
    BACKGROUND/OBJECTIVES: Antipsychotic use is common in US nursing homes, despite evidence of increased risk of morbidity and mortality, and limited efficacy in older adults with dementia. Knowledge, attitudes, and beliefs regarding antipsychotic use among nursing home staff are unclear. The study aim was to describe nursing home leadership and direct care staff members' knowledge of antipsychotic risks, beliefs and attitudes about the effectiveness of antipsychotics and nonpharmacologic management of dementia-related behaviors, and perceived need for evidence-based training about antipsychotic medication safety. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: Survey of leadership and direct care staff of nursing homes in Connecticut was conducted in June 2011. Questionnaire domains included knowledge of antipsychotic risks, attitudes about caring for residents with dementia, satisfaction with current behavior management training, beliefs about antipsychotic effectiveness, and need for staff training about antipsychotics and behavior management. RESULTS: A total of 138 nursing home leaders and 779 direct care staff provided useable questionnaires. Only 24% of nursing home leaders identified at least 1 severe adverse effect of antipsychotics; 13% of LPNs and 12% of RNs listed at least 1 severe adverse effect. Fifty-six percent of direct care staff believed that medications worked well to manage resident behavior. Leaders were satisfied with the training that staff received to manage residents with challenging behaviors (62%). Fifty-five percent of direct care staff felt that they had enough training on how to handle difficult residents; only 37% felt they could do so without using medications. CONCLUSIONS: Findings suggest that a comprehensive multifaceted intervention designed for nursing homes should aim to improve knowledge of antipsychotic medication risks, change beliefs about appropriateness and effectiveness of antipsychotics for behavior management, and impart strategies and approaches for nonpharmacologic behavior management. Elsevier Inc. All rights reserved.
    Source

    Lemay CA, Mazor KM, Field TS, Donovan J, Kanaan A, Briesacher BA, Foy S, Harrold LR, Gurwitz JH, Tjia J. Knowledge of and perceived need for evidence-based education about antipsychotic medications among nursing home leadership and staff. J Am Med Dir Assoc. 2013 Dec;14(12):895-900. doi:10.1016/j.jamda.2013.08.009. Link to article on publisher's site

    DOI
    10.1016/j.jamda.2013.08.009
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/37255
    PubMed ID
    24074962
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jamda.2013.08.009
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