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Rethinking psychotropics in nursing homes

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In reply: We thank Westbury and Peterson, and Mykyta for highlighting some of the issues raised in our article.1

While we acknowledge the important contribution of providing education programs to existing staff, staff education alone is insufficient to address the complex issues affecting psychotropic drug use in nursing homes.1 Better access to appropriately trained staff in nursing homes, including general practitioners, geriatricians, psychogeriatricians, psychologists, pharmacists, nurses or nursing aids, is required to provide safer alternatives to psychotropics. As we discussed, provision of these services may require changes to our health care and funding models.1

Inappropriate use of psychotropics in nursing homes is a hazard that requires comprehensive risk management strategies. The Australian Work Health and Safety Regulations require risks to be managed according to a hierarchy of risk control, in which education is among the lowest controls and providing safer alternatives is among the highest.2 The hierarchy of risk control may be applied to psychotropic use in nursing homes as follows: