Abstract/Summary

Introduction: Treating the behavioural and psychological symptoms of dementia with antipsychotics can cause detrimental side-effects but their use in care homes remains problematic with the views of professionals not fully explored. Aim/question: To develop an in-depth explanatory model about inappropriate prescribing of antipsychotics in dementia within care homes. Methods: Twenty-eight participants from eight different professional groups with a role in shaping treatment decisions in dementia care were recruited and interviewed. The audio-recorded interviews were transcribed and analysed using constructivist grounded theory. Results: When patients with dementia present with behavioural and psychological symptoms, the prescribing of antipsychotics allows the multitude of work in a care home to be managed; the effectiveness of antipsychotics is more perceptible than their side-effects. This perceived usefulness strengthens beliefs that these medications ought to be prescribed again in future situations, generating a self-fulfilling prophecy. Discussion: Our findings may partly explain why the launch of the national dementia strategy in England has been found not to have reduced antipsychotic prescribing in care homes. Implications for practice: Positive perceptions based on past experiences with antipsychotics should be challenged through future interventions that tackle inappropriate prescribing using a behaviour change technique for example better highlighting adverse consequences of prescribing.