Antipsychotics are commonly used off-label in people with dementia to manage problem behaviors or psychotic symptoms.  They have modest efficacy for this purpose, and serious adverse effects including an increased risk of stroke and mortality.  A recent study by the Office of Management and Budget for the Department of Health and Human Services found that 22% of antipsychotics in nursing home residents were used inappropriately.  This led to a current CMS quality initiative to improve behavioral health and reduce unnecessary antipsychotic use in nursing home patients.

The IA-ADAPT toolkit includes pocket guides and an algorithm to guide proper evaluation, non-drug management, and antipsychotic selection and monitoring in dementia patients.  Of special interest to pharmacists, there is also a pocket guide that lists drugs that may contribute to delirium or problem behaviors in people with dementia.  We hope that these tools and training will help you provide the best possible care for your patients with dementia.