College of Psychiatric and Neurologic Pharmacists

This presentation will provide participants an overview of the medico-legal considerations regarding treatment of neuropsychiatric symptoms in patients with dementia. The presentation will specifically examine how impaired cognition inherent in dementia impacts the traditional issues of informed consent and decisional capacity.  Assuming one has decided to implement antipsychotic medication for this vulnerable population, informed consent must be obtained from an appropriate individual.  The existence of decisional capacity is what truly makes the consent “informed” and thus must be independently assessed at the outset of any clinical encounter.  During this presentation the clinical assessment of decisional capacity will be reviewed.  Alternative strategies for obtaining informed consent will also be highlighted.  As explained during the first session on this topic, the decision to medicate dementia-related behaviors should not be made lightly because of the increased morbidity and mortality flowing from these interventions.  Unfortunately, litigation is common following adverse events in nursing homes when medication decisions are blamed for patient harm.  Accordingly, specific management/documentation strategies will be discussed with goals of improving communication, minimizing lawsuits, and most importantly preventing patient harm.  During this presentation, the audience will have several opportunities to participate via case based discussions and the use of audience response technology.

1. Describe the elements of informed consent pertinent to the use of antipsychotic medication in elderly patients to treat behavioral disorders associated with dementia.
2. Identify essential elements in a progress note appropriate to the use of antipsychotic medications for the treatment of dementia-related psychosis.
3. Analyze a situation involving behavioral disturbance in an elderly patient for the treatment approach most consistent with legal and regulatory standards.

Activity Dates: 05/02/2011 - 05/01/2014
ACPE Contact Hours: 1.0
ACPE Number: 0284-9999-11-012-H03-P (Application)
Nursing Credit Reminder: Note that ACPE and ACCME credit is accepted for certification renewal.

This course is provided online at cpnp.org and consists of the speaker audio and slides. A PDF file of the slides is also provided and access is available to participants indefinitely although ACPE credit is available only through the course expiration date.

Participants in this course must complete an examination and achieve a score of 60% or greater. Successful completion of the course also requires the completion of a course evaluation. ACPE statements of credit can be retrieved by participants online at cpnp.org immediately upon successful completion of the course.

If you are a pharmacist, nurse practitioner or other healthcare professional involved in the medication therapy management of psychiatric and/or neurological patients, we invite you to participate in this online course.

Supported by an educational grant from Janssen, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc., administered by Ortho-McNeil Janssen Scientific Affairs, LLC and Lilly USA, LLC.

This programming was supported in part by grants from Bristol-Myers Squibb, Cyberonics, Merk and Sunovion.