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P27 - Behavioral Screening Using the Neuropsychiatric Inventory Questionnaire to Assess Appropriateness of Antipsychotic Prescribing Practices in Patients with Dementia

Background: Strategies to ensure “appropriate” prescribing of antipsychotics in behavioral and psychological symptoms of dementia (BPSD) are limited.

Problem: In a metropolitan primary care setting, antipsychotic medications were being inappropriately prescribed for patients with BPSD at a rate of 45%, a result of lack of knowledge about appropriate prescribing practices for continuation and discontinuation.

Methods: Utilizing the IHI model for improvement, a quality improvement project was implemented to reduce inappropriate prescribing in the primary care practice. The neuropsychiatric inventory questionnaire (NPI-Q) tool was utilized to support appropriate prescribing of antipsychotic medication use in BPSD. Eight providers participated in the QIP and 87 eligible patients were screened using the NPI-Q tool. Outcome measures of this project were to reduce inappropriate prescribing from 45% to 30%, and reduce adverse events from 9% to 4%.

Results: Inappropriate antipsychotic prescribing was reduced to 19%. Adverse events were reduced to 6%.

Discussion and Conclusion: Goal outcome measures were achieved through provider education and utilization of the NPI-Q tool.  

Learning Outcome: After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.


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