clinical focus
Kicking the prescription habit
Royal commission witness
says few people benefit from
psychotropic drugs.
Eddy Strivens interviewed
by Conor Burke
A
ssociate professor Eddy Strivens gave witness testimony
to the first hearing of the aged care royal commission.
As the president of the Australia New Zealand Society
of Geriatric Medicine, Strivens was called to give background on
some issues facing the sector and, more importantly, the residents
and patients.
His testimony covered the role of geriatricians, as well as the
issues of consent and mental health in aged care. He also talked
about the use of psychotropics and their effect on pain, dental
health and dementia.
Strivens recommended that the use of psychotropic drugs in
dementia treatment be reduced, as he believes it is only effective
10 per cent of the time.
“We see probably about 80 per cent of people in residential care
with dementia on one form of psychotropic. And remember this
isn’t just antipsychotics, this is antidepressants, this is sedatives as
well, and around 10 per cent of those [people] might benefit,” he
told the commission.
Aged Care Insite spoke with Strivens to learn more about his
position on psychotropics in aged care.
26 agedcareinsite.com.au
ACI: As a geriatrician, what is the scope of your role?
ES: Geriatricians are physicians with skills, training and expertise
in the care of complex, frail, older people. We’re physicians,
similar to cardiologists and gastroenterologists, and have gone
through a training program with the Royal Australasian College of
Physicians. Often, from qualification as a doctor to qualification as
a consultant geriatrician could take anything from 10 to 12 years of
training and work experience.
Geriatricians are experts at looking at the care of complex
older people. We successfully treat many conditions common
to older people, and through that professional assessment and
tailored intervention, really help many older people maintain their
independence and remain at home.
Where do you primarily treat patients?
Geriatricians work across the whole care continuum. Many
are employed through hospitals and work across acute care,
subacute care (which can be either older persons’ evaluation and
management or rehabilitation), through to community-based
rehabilitation and assessment of people in homes or in outpatient
clinics or day hospitals, through to residential aged care. We can
look after people across the whole care continuum.
We have some geriatricians who work exclusively in hospitals,
some who work exclusively in the community, some who work
privately, and many who work a combination of public and private.
You were called recently to give testimony to the royal
commission. What was the primary reason you were called?
It was about giving some background to the commission on
the medical issues affecting older Australians, and looking at
developing a lexicon and baseline on these conditions for the