Psychotropic medication deprescribing in residential aged care facilities: An exploratory study of the knowledge and attitudes of family members of residents with dementia.

Objectives: General practitioners face many barriers to deprescribing psychotropic medications in people with dementia in nursing homes, including a lack of knowledge about their medication histories. This study explored the knowledge of family members about residents' medications and their willingness to support deprescribing.

Methods: Sixty-six family members of residents from seven residential aged care facilities participated in this cross-sectional study.

Clinical Simulation Training in Geriatric Medicine: A Review of the Evidence and Lessons for Training in Psychiatry of Old Age.

Clinical simulation encompasses a broad range of methods and techniques that allow clinical skills to be rehearsed and practiced away from the clinic before being applied to real patients. As such, preparation of doctors and other healthcare professionals for safe clinical practice is one of its main aims. The objective of this paper was to review the evidence regarding the use of clinical simulation training in geriatric medicine education and consider how the findings may be translated to education in the closely related field of psychiatry of old age.

Programmatic Assessment of Professionalism in Psychiatry Education: A Literature Review and Implementation Guide.

Programmatic assessment is being adopted as a preferred method of assessment in postgraduate medical education in Australia. Programmatic assessment of professionalism is likely to receive increasing attention. This paper reviews the literature regarding the assessment of professionalism in psychiatry.

Objective Structured Clinical Examination (OSCE) in Psychiatry Education: A Review of Its Role in Competency-Based Assessment.

Over the last two decades, Objective Structured Clinical Examination (OSCE) has become an increasingly important part of psychiatry education and assessment in the Australian context. A reappraisal of the evidence base regarding the use of OSCE in psychiatry is therefore timely. This paper reviews the literature regarding the use of OSCE as an assessment tool in both undergraduate and postgraduate psychiatry training settings.

Psychodynamic Leadership Approach and Leader-Member Exchange (LMX): A Psychiatric Perspective on Two Leadership Theories and Implications for Training Future Psychiatrist Leaders.

An increased emphasis in recent years on psychiatrists as healthcare leaders has not only drawn attention to the skills they can bring to this role but has also raised questions about how to best train and prepare them to assume leadership responsibilities. Such training should not be conducted in isolation from, and oblivious to, the wide-ranging expertise in human behaviour and relationships that psychiatrists can bring to the leadership arena. The aim of this theoretical paper is to draw attention to how psychiatrists can use their existing knowledge and skill set to inform their understanding of leadership theory and practice.

Quality indicators of psychotropic prescribing to people with dementia in aged psychiatry inpatient units.

Objectives: To develop indicators of safe psychotropic prescribing practices for people with dementia and to test them in a convenience sample of six aged mental health services in Victoria, Australia.

Method: The clinical records of 115 acute inpatients were checked by four trained auditors against indicators derived from three Australian health care quality and safety standards or guidelines. Indicators addressed psychotropic medication history taking; the prescribing of regular and 'as needed' psychotropics; the documentation of psychotropic adverse reactions, and discharge medication plans.

Alfentanil anesthetic augmentation lengthens seizure duration in electroconvulsive therapy with older people.

Electroconvulsive therapy (ECT) prescription rates rise with age, making it important that treatments be made as effective and safe as possible (Plakiotis et al., 2012). Older people are vulnerable to post-treatment confusion and to subsequent deficits in attention, new learning, and autobiographical memory (Gardner and O'Connor, 2008).

The Clinical and Service Outcomes of Unilateral and Bilateral ECT Electrode Placements in Australian Aged Psychiatry Services.

Objective: The aim of the study was to determine whether depressed aged inpatients treated with brief pulse unilateral electroconvulsive therapy (ECT) differed from those treated with bilateral (bitemporal or bifrontal) ECT with respect to numbers of treatments, length of hospital admission, changes in scores on depression and cognitive scales, and serious adverse effects.

Methods: An audit of routinely collected data regarding 221 acute ECT courses in 7 public aged psychiatry services in Victoria, Australia.

Results: Patients given unilateral, bifrontal, and bitemporal treatments were similar with respect to personal, clinical, and treatment characteristics.

Deprescribing psychotropic medications in aged care facilities: the potential role of family members.

There is widespread concern in Australia and internationally at the high prevalence of psychotropic medication use in residential aged care facilities. It is difficult for nurses and general practitioners in aged care facilities to cease new residents' psychotropic medications when they often have no information about why residents were started on the treatment, when and by whom and with what result. Most existing interventions have had a limited and temporary effect and there is a need to test different strategies to overcome the structural and practical barriers to psychotropic medication cessation or deprescribing.