Abstract
Polypharmacy in older nursing home patients is a well-documented concern. Several large studies have demonstrated an association between treatment with antipsychotics and increased morbidity and mortality in people with dementia, and the economic impact of polypharmacy is also substantial, with annual medicationrelated issues costing $7.6 billion in nursing facilities alone. We chose to use the Assess, Review, Minimize, Optimize, Reassess (ARMOR) protocol for our team-based intervention to address inappropriate prescribing in older residents. A reduction in the use of psychotropic medications was associated with an improvement in activities of daily living and fewer reports of depression but was also linked to an increase in the rate of falls and reports of pain. The lower use of antipsychotics also appears to unmask untreated anxiety, expressed in the results as the increased rate of antianxiety medications.
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