General practitioners, including those who regularly consult in aged care homes, will have access to a new expert advice services to help them manage the clinical needs of patients with dementia complicated by behaviour and psychological symptoms.
Dementia Support Australia with the support of the Department of Health has launched the GP Advice Service offering direct email access to psychogeriatricians and geriatricians when treating a patient with Behaviours and Psychological Symptoms of Dementia (BPSD).
The nation’s 31,000 GPs can access the DSA team through the new email service at gpadvice@dementia.com.au
Nonpharmacological strategies should be an important part in the management of dementia complicated by BPSD and, in fact, be the mainstay of treatment in most patients.
DSA head of clinical services, Associate Professor Steve Macfarlane
Advice on treatment strategies will be based on clinical information provided by the GP, including an overview of the patient’s presentation and history.
GPs are welcome to provide a telephone number if they prefer a call-back for a one-on-one discussion.
DSA head of clinical services, Associate Professor Steve Macfarlane, pictured above left, said it was now generally accepted that psychotropic medications have a limited role in the management of BPSD.
“Nonpharmacological strategies should be an important part in the management of dementia complicated by BPSD and, in fact, be the mainstay of treatment in most patients,” Macfarlane said.
“We want to do all we can to support GPs to consider alternatives to these medications.”
BPSD may include psychosis, agitation and aggression, depression, anxiety, apathy, impulsivity, pacing, vocalisations, appetite and eating changes, sleep disturbances, distress during personal care and wayfinding difficulties.
The recent Royal Commission into Aged Care Quality and Safety identified overuse of psychotropic medication in aged care residents with BPSD as a significant issue contributing to adverse outcomes, and highlighted the minimal training that doctors receive in BPSD management.
We recognise that in the day-to-day work of running their practice it may not be possible for GPs to make a call or discuss a patient during normal business hours. An email response offering clinical advice from a medical specialist is a great solution.
Head of dementia professional services at DSA, Marie Alford
Some of the adverse outcomes associated with psychotropic medications in dementia include increased risks of death, falls, weight gain, hypertension and diabetes, a restriction on the patient’s ability to swallow and an increase in the risks of aspiration, pneumonia, and other respiratory conditions.
These changes in behaviour are thought to have many catalysts and causes, including the consequences of the progressive nature of the many organic conditions linked to dementia, or on many occasions, a reasonable response to unmet needs, pain or changing circumstances.
Up to 95 per cent of people living with dementia will experience forms of BPSD during their journey with the disease and many of them will be wrongly prescribed medications or chemically and physically restrained.
Head of dementia professional services Marie Alford said the GP Advice Service was designed be as easy as possible for busy General Practitioners to access.
“We recognise that in the day-to-day work of running their practice it may not be possible for GPs to make a call or discuss a patient during normal business hours,” Ms Alford said.
“An email response offering clinical advice from a medical specialist is a great solution.”
If needed, GPs can be offered further support through a range of other DSA programs including the Dementia Behaviour Management Advisory Service (DBMAS) and the Severe Behaviour Response Team (SBRT).
DSA is funded by the Australian Government and operates 24/7, 365 days a year to improve the quality of life of people living with dementia and their carers who are experiencing behavioural changes. It brings together dementia expertise from across the aged care industry nationally.
For more information on the GP Advice Service, click here.
