P3‐317: ANALYSIS AND EVOLUTION OF THE PRESCRIPTION OF ANTIPSYCHOTICS IN A BELGIAN PSYCHOGERIATRIC WARD AFTER THE INTERVENTION OF A CLINICAL PHARMACOLOGIST AND AFTER TRAINING THE MEDICAL TEAM

Antipsychotics are frequently overused in the management of Behavioral & Psychological Symptoms of Dementia (BPSD), given their low risk-benefit ratio. This study aims to investigate if antipsychotic prescriptions in an acute geriatric ward can be reduced following the delivery of a non-pharmacological training program to care team members and the addition of a clinical pharmacist to the care team. This is a single-centre retrospective observational study based on the systematic review of computerized hospitalization records of patients who were admitted to the Psychogeriatric ward at André Vesale University Hospital in Belgium over two 12-month periods. We compared antipsychotic prescribing practices at baseline (2013-14) to data collected 3 years later (2016-17). In the period that intervened, we delivered training about non-pharmacological treatments to the care team and introduced a clinical pharmacist to the team, whose role was to verify all antipsychotic prescriptions. Dependent measures were the type of medication used, the daily dose prescribed and the daily dose defined (DDD). In 2013-14, there were 410 admissions and 163 received at least one dose of antispychotic. In 2016-17, there were 404 admissions and 167 patients received at least one dose. The samples were matched for gender, age, comorbidities, geriatric assessment, type of dementia and psychiatric diseases. Atypical antipsychotics were favored in both cohorts with a strong preference for quetiapine followed by risperidone. Average medication use, expressed as a function of DDD for each molecule per patient reported per 100 days of hospitalization, was 10.64 +/- 15.56 in 2013-14 compared to 7.49 +/- 9.38 in 2016-17. This corresponds to a significant decrease of 29% between our 2 cohorts (p = 0.05). This study shows that it is possible to improve antipsychotic prescription practices in a geriatric ward through the intervention of a clinical pharmacist and the delivery of non-pharmacological training to the care team. The management of the BPSD is challenging; when non-pharmacological treatments do not suffice to manage symptoms, antipsychotics may be used. With effective training and oversight, we show that they can be utilised effectively in lower doses and for shorter periods of time.