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Choosing Wisely Talks | Choosing Wisely and Deprescribing: Managing Dementia Without Antipsychotics - Shared screen with speaker view
Jaana Ranchithan
20:29
https://choosingwiselycanada.org/events/past/
Jaana Ranchithan
20:54
https://www.bmj.com/content/376/bmj-2021-069187.long
aprill negus
34:13
how would you implement these strategies in long term care homes where staffing/ supports are an issue?
Karen Born
34:36
Thanks for this question April. We will pose it to the panel.
Jaana Ranchithan
38:43
Please feel free to enter your questions or comments in the chat box.
Michelle Henry
39:24
Insights regarding safety between 1st and 2nd gen antipsychotics?
Sean Slaney
41:09
There are many PRIVATE facilities, who are obviously concerned about the "bottom line", that employ staff with minimal or no education with respect to Anti-psychotics. Does anyone have any suggestion how to champion this process at these facilities?
Angie Palen
42:43
Sounds like you have a wonderful physician Roger!
Kathleen O'Donnell
43:55
Any particular resource you would recommend for interdisciplinary teaching? It can be hard to do the topic of antipsychotics vs. non-medication interventions justice in a short conversation on the ward
Rohit Moghe
44:40
Pharmacist from Pennsylvania, USA
Thalia Jacobo
45:16
Pharmacist from México
Julia Berglund
45:19
Geriatric Nurse Practitioner
Johanna Trimble
49:30
How can we let the public know about these issues and especially the non-pharmaceutical, lifestyle methods that have to be put in place by the patient and family? Doctors, especially less experienced ones in this area of care, usually reach for the prescription pad and often have no time to do anything else.
alidkea
50:28
As a community pharmacist I’m wondering how I can best support my patients who present new prescriptions for antipsychotic medications for neuropsychiatric symptoms, as I find this is often still the first go to strategy for many prescribers.
Karen Born
53:29
http://www.dementianetworkcalgary.ca/dlh-menu
Karen Born
53:36
Link to ‘Dementia lives here’ FYI
Merv Pichlyk
53:38
when antipsychotics are employed, do you have a time frame for measuring effectiveness and at what point would one consider a dose increase, change of agent , or actual discontinuation.
Michelle Henry
53:58
Regarding the safety of quetiapine, what reference can we source to speak to colleagues regarding same?
Chris Kwiatkowski
54:41
Please define low dose Quetiapine.
Jennifer Loucks
54:44
The government has been doing commercials on increasing the awareness of dementia. Modifiable risks factors including non-pharm interventions could be shared through commercials, education and advocacy
Jennifer Watt
54:48
https://www.bmj.com/content/376/bmj-2021-067003
Jennifer Watt
55:27
This is the resource for stroke risk from using atypical antipsychotics that we discussed today. All treatment dose ranges are defined in the methods.
Jennifer Watt
56:49
Low dose quetiapine is defined as <125mg/day total daily dose.
Johanna Trimble
57:35
I am watching a friend losing more and more cognitive function and part of this has to do with her husband being very ill (both at home). How much does stress and grief impact on cognitive function for those already diagnosed with dementia.
Michelle Henry
57:59
What dose range for quetiapine do you use?
aprill negus
58:17
what about using ssri's and benzos in dementia- I get a lot of requests from nurses and families for ativan
Karen Born
59:38
https://choosingwiselycanada.org/perspective/antipsychotics-toolkit/
Phamie Gotaas
01:01:36
In our LTC we often use as needed (PRN) low dose antipsychotics with behaviors to assess if we are likely to see improvement before starting a more regular dose.
Karen Born
01:02:05
https://choosingwiselycanada.org/perspective/toolkit-benzos-primary-care/
Karen Born
01:02:12
https://choosingwiselycanada.org/perspective/benzos-hospital-toolkit/
Johanna Trimble
01:03:58
Many people are on antipsychotics in LTC because they came in on them from the hospital where they were given for delirium and never taken off.
Johanna Trimble
01:05:25
Good resources from BC for stopping meds: https://sharedcarebc.ca/our-work/polypharmacy
Jennifer Loucks
01:07:25
In BC they have just announced that Dr's can prescribe for a person to get a year pass to a National Park. Why can we not implement prescribing non-pharm interventions ie. recreation therapist, music therapist etc.
Johanna Trimble
01:10:20
Good pamphlet from Fraser Health in BC for family and residents attached.
Mieko Ise
01:10:27
Caregivers generally know the "patient" best, therefore caregivers and patients must be made comfortable to ask questions about the doctor's recommendations. Also be given the time to ask questions.
Barbara Liu
01:15:04
https://healthstandards.org/public-reviews/long-term-care-services/
Deb Schick
01:15:27
Thank you Roger for your perspective. I really appreciate learning from you.
Angie Palen
01:16:59
Great point Roger! patients need direct advice, and specific tools to improve their health.
Rohit Moghe
01:17:05
Cookbook by Neurologists: https://www.amazon.com/30-Day-Alzheimers-Solution-Definitive-Preventing/dp/0062996959
Thalia Jacobo
01:17:05
Very enriching to listen to Roger!
Brenda Etheridge
01:17:10
thank you all :)
Jaana Ranchithan
01:17:28
Survey Link (English): https://www.surveymonkey.com/r/G86RNB3Survey Link (French): https://fr.surveymonkey.com/r/GL7L87H
Jaana Ranchithan
01:17:51
If you have any questions following this presentation, please email us at info@choosingwiselycanada.org.
Jaana Ranchithan
01:18:17
February 24: https://choosingwiselycanada.org/event/cwtalks-feb24/
Jaana Ranchithan
01:18:25
March 9: https://choosingwiselycanada.org/event/cwtalks-march2022/
Jaana Ranchithan
01:18:43
https://choosingwiselycanada.org/perspective/abstracts-2022/