Finland’s Revised Dementia Treatment Guidelines: Impact on Psychotropic Drug Use
Finland’s Revised Guidelines: A Shift in Dementia Treatment
A recent study conducted by the University of Eastern Finland delved into the effect of Finland’s updated dementia treatment guidelines on the use of psychotropic drugs among elderly dementia patients. The guidelines, which were revised in 2017, advocate for non-pharmacological methods to manage dementia-related behavioral symptoms. However, the study found that these new guidelines did not significantly reduce the use of psychotropic drugs among dementia patients between 2009 and 2020, even though there was a slight decrease in the number of new users.
Disseminating Evidence-Based Treatments
The revised guidelines have aimed to facilitate the distribution of evidence-based treatments and augment the effectiveness of dementia treatments. These guidelines suggest managing dementia-related behavioral symptoms primarily using non-pharmacological methods, and avoiding psychotropic drugs. Instead, they propose alternative treatments such as changes in healthcare professionals’ communication methods and music therapy. However, the study suggests that while clinicians were more likely to adhere to these new guidelines when initiating a new medication, they were less inclined to discontinue an existing one.
Measuring the Effectiveness of New Guidelines
The effectiveness of the revised guidelines has been complex to assess due to multiple factors including the absence of a control group, the slow spread of awareness about the revised guidelines, and other societal changes like fluctuations in medication prices or reimbursements.
Impact on Psychotropic Drug Use
The study examined purchases of anti-dementia medication by Finns aged 65 and older between 2009 and 2020. In 2009, 57% of 43,750 users of anti-dementia drugs also used at least one psychotropic drug. By 2020, the number of anti-dementia drug users had increased, with 52% of 105,683 users also taking psychotropic drugs.
First Population-Level Study on Clinical Guideline Implementation
This research marks the first time the implementation of clinical guidelines has been studied at a population level using data from the Finnish Prescription Register. The lack of similar research worldwide underscores a gap in our understanding of how clinical guidelines affect the use of psychotropic drugs in dementia treatment.
Collaborative Research Effort
The study was a joint effort between researchers from the University of Eastern Finland and the Finnish Medicines Agency (Fimea), and was part of the MEDIFF research project. Funded by the Social Insurance Institution of Finland, the project seeks to develop strategies to promote rational use of medicines among older people.
Looking Ahead: The Need for Further Research
Despite the new knowledge gained from this study, further research is necessary. Based on previous studies and clinical guidelines, effective dementia treatment relies on individualized treatment paths and multi-professional collaboration. More research is needed to understand the factors that influence prescription practices, the implementation of pharmacotherapy in line with clinical guidelines, and the availability of non-pharmacological treatment options.
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