Use of the neuropsychiatric inventory questionnaire to assess antipsychotic prescribing practices in patients with dementia: A quality improvement project.

Strategies to ensure appropriate prescribing of antipsychotics in behavioral and psychological symptoms of dementia (BPSD) are limited in the primary care setting. In a metropolitan primary care setting, antipsychotic medications were found to be inappropriately prescribed in 45 % of patients with BPSD as defined by American Psychiatric Association (APA) clinical guidelines. A quality improvement project (QIP) was implemented to educate providers on appropriate prescribing for BPSD using the Neuropsychiatric Inventory Questionnaire (NPI-Q) tool. Outcome measures were to reduce inappropriate prescribing from 45 % to 30 % and reduce adverse events from 9 % to 4 %. At the completion of the project, results exceeded the goal with a reduction of inappropriate prescribing to 19 % and, achieved a 3 % reduction of adverse events. This project demonstrates the benefit of using the NPI-Q tool as a guideline for other primary care providers to safely establish prescribing practices for patients with BPSD.