Does the Use of Psychotropic Medication go up During Focused Efforts to Bring Coercion and Restraint Down?

Abstract

Introduction

Antipsychotic or anxiolytic medicine is widely used in agitated patients in risk of coercion. However this medication is also known to contribute to cardio-vascular disease and reduced life expectancy. Department of Psychiatry in Aabenraa, Denmark participates in a nation-wide Danish project supporting efforts to reduce coercion and restraint. Our hypothesis is that reduction of coercion might lead to unwanted increase in doses of psychotropic medication.

Objective

To document the use of psychotropic medication during the project period, in order to learn more about the impact of interventions to reduce coercion and restraint on psychopharmacological treatment.

Aim

To compare type and doses of psychotropic prescriptions during the project period with the time before implementation.

Methods

Cohort study of patients in risk of agitation and coercion admitted to the wards during first quarter of 2013 and 2016. Eligible patients were diagnosed as having organic mental disorders, substance abuse, psychotic disorders, mania, bipolar affective disease or personality disorders (ICD-10: F0x, F1x, F2x, F30-31, F60). Primary outcome is the exposure to antipsychotic medication measured as defined daily doses, and secondary outcomes are exposure to benzodiazepines, polypharmacy and compliance with guidelines on agitated patients.

Results

Data collection is carried out during autumn of 2016, and the results will be presented at the congress.

Conclusions

Results from this study will contribute to our understanding of the implications of the initiative to reduce restraint and coercion in psychiatry. The results will also sharpen our awareness of possible inexpedient practice.

Disclosure of interest

The authors have not supplied their declaration of competing interest.