Healthy Skepticism Library item: 927

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Publication type: news

Toneguzzi M.
Drugs 'overused' in care centres: Tranquillizers given to a third of residents
Calgary Herald 2005 Mar 27

Full text:

Tranquillizers are being over-prescribed to residents of long-term care centres, according to a two-year study by University of Calgary and University of Lethbridge researchers.

The study found that about one-third of residents in 24 long-term care facilities received a major or minor tranquillizer drug, such as anti-psychotics and benzodiazepines.

Too many drugs are being used, said Dr. Paddy Quail, an author of the study.

Quail is medical director of Intercare, a long-term care facility in Calgary. He’s also medical director of home care for the Calgary Health Region and a clinical assistant professor in the U of C’s faculty of medicine.

“I would like to see a more critical use of these medications in our care centres and more judicious use and more non-pharmacological interventions and tapering of the medications when they’re no longer required,” said Quail.

The research was conducted primarily by Quail and Dr. Brad Hagen of the University of Lethbridge. The study was based on data collected from 2001 to 2003.

It found the use of these drugs in smaller, rural long-term care facilities was about half that of the use found in larger urban facilities.

An educational initiative targeting physicians, pharmacists, nursing staff and family members had little influence on the use of these medications.

The research was funded by the Alberta Heritage Foundation for Medical Research.

The study did not look at the reasons for the overuse of the drugs.

The Alberta Liberals have asked Health and Wellness Minister Iris Evans to review the situation to ensure the drugs are being used appropriately and only when necessary.

“Residents in long-term care facilities with dementia or Alzheimer’s disease are sometimes given anti-psychotic (major tranquillizers) or benzodiazepines (minor tranquillizers) to control agitated or aggressive behaviour,” said Hagen.

“It is important to realize that there are significant numbers of older persons with dementia in long-term care whose behaviours may pose safety issues for themselves, staff and other residents.”

In such cases, Hagen said, physicians and staff may use these drugs as a last resort to help ensure the safety of those at the facility.

But it is important these drugs be given only as a last resort because of the risk of significant side-effects, such as falls, sedation and neurological problems, he warned.

The researchers looked at 2,500 people in 10 urban and 14 rural long-term care facilities in southern Alberta.

Half of the facilities received an education intervention for physicians, nursing staff, pharmacists and family members. The other half did not.