Supporting the appropriate use of psychotropic medicines in aged and disability care

Royal Commissions into the aged-care and disability sectors revealed significant concerns about the inappropriate use of psychotropic medicines as chemical restraint in people with cognitive disability or impairment. In response, the Australian Commission on Safety and Quality in Health Care developed the Psychotropic Medicines in Cognitive Disability or Impairment Clinical Care Standard (the Standard), aiming to guide psychotropic use and ensure best practice in supporting people with cognitive disability or impairment. This article provides an overview of the Standard and its application in the aged-care and disability sectors. The Standard promotes person-centred care and prioritises thorough assessment, non-medication strategies, and the development of individual behaviour support plans before considering psychotropic medicines. It encourages healthcare services to have clear policies around psychotropic use, including the need for documentation of non-medication strategies trialled before such use, and for monitoring the effectiveness of any psychotropic medicine prescribed. Informed consent is a regulatory requirement before using psychotropic medicines as a form of restrictive practice. Clear treatment goals, clinical handover during transitions of care, and regular psychotropic review and deprescribing are emphasised in the Standard to minimise harm, particularly in cases of long-term use and psychotropic polypharmacy.