1Professor Parastou Donyai, 1,2 Tim Langran and 2Sundus Jawad
1Department of Pharmacy, University of Reading, Reading, RG6 6UB; 2Berkshire CCG
Study Background: The behavioural and psychological symptoms of dementia (BPSD) describe a set of distressing symptoms (e.g. anxiety, aggression, calling out, wandering) that can affect the overall quality of life and the quality of care provided to those living with dementia. Antipsychotics are sometimes prescribed for the management of BPSD but they are associated with an increased risk of adverse effects including stroke and death. The high use of antipsychotics has been reported in care home settings, where one third of patients have dementia or memory problems. Studies have found that on-site staff request to prescribe antipsychotics is one of the major factors responsible for problematic
prescribing. There is in fact a dearth of evidence in the literature focussed on interventions that aim to change nursing staff beliefs and behaviour toward antipsychotic prescribing. Moreover, the theoretical underpinning of much of the work focussing on behaviour change in this area is unclear as studies have not made explicit the theoretical framework of their interventions. This provided the rationale for adapting an intervention based on Behaviour Change Techniques (BCT) to change nurses’ attitude toward prescribing in the current project.
Aim: To evaluate the effectiveness of behavioural change intervention on staff attitudes toward the use of antipsychotics in people with dementia in care homes (n=6) and on the actual prescribing of antipsychotics for these residents.
Methodology: This is a mixed method study, planned to be completed in 5 steps. Step 1: Antipsychotic in Dementia Attitude Questionnaire (ADAQ) constructed from an existing nurses’ behaviour questionnaire was revised using Theory of Planned Behaviour (TPB) construct procedure as described in Ajzen (2006). The resultant questionnaire (ADAQ-v1) will be subjected to content validity check and followed by pilot testing of questionnaire. The finalised version of questionnaire going to be named as ADAQ-vf will be used to determine nurses’ attitude toward prescribing of antipsychotics. Step 2:The researcher will review patient medication record by physical visit to each care home to monitor prescribing of antipsychotics in residents. Step 3: A work shop will be conducted to increase the understanding of staff about managing BPSD through posters and quick reference cards. Step 4: After 6 and 12 months of the study, the perception of nursing staff using ADAQ-vf and prescribing of antipsychotics for residents will be monitored . Step 5: Usability of the training material will be assessed by interviewing staff at each care homes at the end of the project.