Psychotropic medicines are being over-prescribed and over-used in managing people with disability and the elderly, contributing to falls and weight gain and diminishing wellbeing, according to three key health quality oversight bodies.
In a joint statement, the Australian Commission on Safety and Quality in Health Care (ACSQHC), the Aged Care Quality and Safety Commission (ACQSC) and the NDIS Quality and Safeguards Commission (NDIS Commission) flagged the risks and called for more education on the risks of psychotropic drugs.
They said there was evidence psychotropic medicines are being overprescribed and overused, in particular with older people and people with disability.
In addition to contributing to falls, weight gain and affecting overall wellbeing, the statement said psychotropic medicines are adversely affecting the ability to swallow and increasing the risk for aspiration pneumonia and other respiratory complications.
The quality oversight bodies said there was “little evidence that psychotropic medicines are effective for managing behaviours of concern” and that the inappropriate use of psychotropic medicines has been recognised as a safety and quality issue in healthcare.
Royal Commission
In 2021, the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with a disability released a report on its hearing into ‘Psychotropic medication, behaviour support and behaviours of concern’.
It found people with cognitive disability often experience serious negative consequences as a result of using such medication, ranging from reduced cognitive functioning, nausea, headaches and weight gain, and, in the worst cases, death.
While the ACQSC, NDIS Commission and ACSQHC stated the use of psychotropic medicines can be appropriate for treating a diagnosed mental disorder or physical illness, they wrote that “using psychotropic medicines, such as antipsychotics and benzodiazepines, to calm, soothe, sedate or influence or control the behaviour of people who exhibit behaviours of concern is a restrictive practice and is subject to regulatory oversight”.
The statement said health, aged care and disability support providers are legally required to ensure restrictive practices are only used as a last resort, and that healthcare practitioners and aged care providers require informed consent for the use of psychotropic medicines.
Raising awareness
The ACQSC, the NDIS Commission and the ACSQHC have agreed to work with key individuals and organisations within the health, aged care and disability sectors to reduce the inappropriate use of psychotropic medicines through:
- Raising awareness of the risks associated with inappropriate use of psychotropic medicines amongst healthcare, aged care and disability workforces
- Supporting improvements to the availability and quality of behaviour support planning, and preventative and de-escalation strategies
- Strengthening understanding and capacity for appropriate informed consent, prescribing, dispensing, administration and cessation of psychotropic medicines.
The ACQSC is responsible for regulating the use of restrictive practices, including chemical restraints, in aged care; the ACSQHC leads and coordinates national improvements in healthcare safety and quality, setting National Safety and Quality Health Service Standards; while the NDIS Commission is responsible for regulating the use of restrictive practices, including chemical restraints, in the National Disability Insurance Scheme (NDIS).
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