Author Identifier (ORCID)
Mustafa Atee: https://orcid.org/0000-0002-0837-3245
Abstract
Background: Psychotropic medications are often inappropriately prescribed for behavioural and psychological symptoms of dementia (BPSD), posing significant risks such as falls, stroke and death. Although non-pharmacological interventions (NPIs) are the first-line treatment for BPSD, their use in practice remains limited. Objectives: This study explored general practitioners’ (GPs’) and physicians’ perspectives on using psychotropic medications compared to NPIs for managing BPSD in Australian residential aged care homes (RACHs). Design: Semi-structured online in-depth interviews were conducted with GPs and physicians managing BPSD in Australian RACHs. Methods: The interviews were audio-recorded, transcribed and analysed using inductive thematic analysis, with transcripts coded using NVivo 14 to generate themes. Results: Four GPs and eleven physicians were interviewed, and four major themes emerged: (1) knowledge of best practices of BPSD management, (2) awareness of current challenges in BPSD management, (3) non-involvement, blame shifting and rationalisation: perceived reasons for the current challenges and (4) suggested solutions. GPs and physicians were aware of best practices in managing BPSD, highlighting the importance of NPIs as more effective first-line strategies, with psychotropic medications reserved as a last resort. They also admitted that psychotropic over-prescription and inadequate NPI implementation persisted in BPSD management in Australian RACHs. Physician participants often distanced themselves from and blamed the GPs, staff and relatives of residents with dementia for the current problems. Systemic barriers, including insufficient resources, limited care continuity and organisational structures, were also reported to hinder psychotropic deprescribing. Implementing NPIs was deemed to be impeded by inadequate training and low confidence in their effectiveness. The participants suggested strengthening workforce capacity, incentivising NPIs and encouraging interdisciplinary collaboration. Conclusion: The results highlighted the gap between GPs’ and physicians’ knowledge of best practices and actual prescribing practices for BPSD in Australian RACHs. Improved workforce and support for NPIs could reduce reliance on psychotropics and align BPSD management with best practices.
Document Type
Journal Article
Date of Publication
1-1-2025
Volume
15
Publication Title
Therapeutic Advances in Psychopharmacology
Publisher
Sage
School
Centre for Research in Aged Care / School of Nursing and Midwifery
Funders
University of South Australia / Australian Government Research Training Program
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
Ayeno, H. D., Atee, M., Kassie, G. M., Suppiah, V., Widagdo, I., & Nguyen, T. A. (2025). Psychotropic medications versus non-pharmacologic approaches for managing behavioural and psychological symptoms in Australian aged care residents with dementia: General practitioners’ and physicians’ perspectives. Therapeutic Advances in Psychopharmacology, 15. https://doi.org/10.1177/20451253251387908