An an article published on October 2, 2018, Behavioural and psychological symptoms of dementia: GPs’ perspective on management highlighted to me on Twitter via Dubhgas Taylor, I want to highlight one of the problems we are facing. It reports on a ‘mixed-methods systematic review by Jennings and colleagues aimed to develop a better understanding of general practitioners’ knowledge, attitudes and experiences of managing BPSDs with the hope to informing future interventions to help GPs.’
The first sentence in the article says:
With rising prevalence, general practitioners are at the frontline of caring for people living with dementia. Some of the most challenging symptoms are the behavioural and psychological symptoms of dementia (BPSD) and it is believed that nearly all people with dementia will develop these symptoms at some stage during the course of the disease (Savva et al, 2009).
To begin with, even citing references as old as 2009 is out of touch. If I did that in an article for my PhD, I would be asked to find more relevant, and accurate data; apart from explaining the historical context of something, it is recommended I mostly use references from the last five years.
The author goes on to say:
“One of the key problems in this area is that the evidence for the management of BPSDs is limited. Although non-pharmacological interventions such as personalised music therapy are recommended as first line treatment, these interventions are not taken up (Marston et al, 2014). On the other hand, commonly used treatments such as antipsychotics have limited evidence and significant side effects.”
My points exactly, so why are we still using the term BPSD, and still being prescribed anti psychotics ad nauseam, when there is little evidence for either? In fact, there is plenty of evidence against the use of antipsychotics for people with dementia, which systematically continues to be ignored.