Reducing the innapropriate use of psychotropic medicines
Psychotropic medicines have an important role to play in managing mental health conditions, however, they can often be prescribed inappropriately as a form of restrictive practice and for extended period of times. We have several resources to support health professionals to reduce inappropriate prescribing of psychotropic medicines.
What are psychotropic medicines?
Psychotropic medicines affect the mind, emotions and behaviour. They are used to treat mental health conditions such as anxiety, depression, schizophrenia, bipolar disorder and sleep disorders, and work by adjusting levels of chemicals in the brain to improve symptoms.
The main groups of psychotropic medicines used to treat mental health conditions and sleep disorders are antipsychotic, antidepressant, and anxiolytic/hypnotic medicines.
Why is there a need to promote appropriate prescribing?
The Royal Commission into Aged Care Quality and Safety and the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability identified that psychotropic medicines are being misused and overused, particularly with older people and people with disability.
The use of psychotropic medicines can be appropriate for treating, or enabling the treatment of, a diagnosed mental disorder or a physical illness or physical condition. However, using psychotropic medicines, such as antipsychotics and benzodiazepines, to calm, soothe, sedate, influence or control the behaviour of people who exhibit behaviours of concern is a restrictive practice and is subject to regulatory oversight.
Joint statement on the Inappropriate Use of Psychotropics Medicines to Manage the Behaviours of People with Disability and Older People
We are working alongside the Aged Care Quality and Safety Commission and the NDIS Quality and Safeguards Commission to reduce the inappropriate use of psychotropic medicines through raising awareness of risks, promoting use of alternative strategies, and strengthening understanding and capacity for appropriate prescribing.
Clinical care standards
The Psychotropic Medicines in Cognitive Disability or Impairment Clinical Care Standard aims to ensure the safe and appropriate use of psychotropic medicines in people with cognitive disability or impairment and uphold their rights, dignity, health and quality of life.
Our easy read version can help people with cognitive disability or impairment understand what the clinical care standard says.
The Delirium Clinical Care Standard was developed to improve pathways of care for people at risk of or experiencing delirium. There are eight quality statements that describe the level of clinical care expected for a specific clinical condition or procedure. Quality statement 7 is Avoiding use of antipsychotic medicines. It states that behavioural and psychological symptoms in a patient with delirium are managed using non-drug strategies, unless these strategies are unsuccessful and there is an imminent risk of the patient harming themselves or others.
These clinical care standards provide critical information for health professionals, health service organisations, and consumers.
National action to support people with cognitive impairment
View our page on cognitive impairment to learn about actions in our National Safety and Quality Health Service Standards that promote safe and quality care for people with cognitive impairment or at risk of delirium.
Background
In 2015, the Australian Atlas of Healthcare Variation identified unwarranted variation in the dispensing rates of antipsychotic medicines for people aged 65 years and over. Upon repeat analysis in 2018, the Third Australian Atlas of Healthcare Variation found that prescription rates of antipsychotic medicines to people aged 65 years and over had decreased; however, the volume of antipsychotic medicines supplied on any given day in the Australian community remained stable, indicating that there has been little change in the overall amount of use during the four years. This prompted a literature review into the use of antipsychotic medicines, amid growing concerns that antipsychotic medicines were being prescribed inappropriately in older people, outside of guideline recommendation, for the management of behavioural and psychological symptoms of dementia or delirium.
Key findings from this review informed revision of the Delirium Clinical Care Standard in 2021, and further work in medicines safety and quality.