The effects of the education program and other factors on the number of sedative medications that older people with dementia regularly consume.

Educational intervention • A multi-strategic, inter-disciplinary intervention (25 nursing homes) will be undertaken to reduce and promote the appropriate use of psychotropics, anti psychotics and benzodiazepines in Residential Aged Care Facilities (RACFs). -The Dementia Training Australia team (DTA) will conduct this intervention at (RACFs). They will provide online training components of the medication consultancy course for RACF staff. This course will be conducted twice and will take approximately 30 minutes. The other part of the medication consultancy training is regular, short educational meetings with change champion groups in the RACFs. DTA will conduct 30-minute meetings (video conferences), group size up to 6 staff members (preferably the Change Champion/s) approx. every 2-4 weeks and there are approx. 8 meetings to complete throughout the Medication Management Consultancy (MMC) which usually run for approx. 6 months. If sites are located in WA, our aim to visit them face to face for the initial meeting and last. DTA team use the OAPQ (knowledge quiz about at T1 and T2), the antipsychotic audit (at T1 and T2) and three DTA surveys: • Survey 1 – provided to any staff member who completed the one-hour online medication management course during the MMC. This is a knowledge translation-type survey, specifically asking staff about the one-hour online course and how this might have changed/influenced their practice. • Survey 2 - provided to the Action Group and Change Champion/s only to mark the end of the MMC. This is a knowledge translation-type survey, specifically asking staff about the MMC as a whole and how this might have changed/influenced their practice. • Survey 3 – provided to the Action Group and Change Champion/s only 3-6 months post-MMC. This is a knowledge translation-type survey, specifically asking staff about the MMC as a whole and how this might have changed/influenced their practice 3-6 months post-MMC. The researchers will be involved by following the process and making sure the data is collected to ensure fidelity and monitor data collection. • A comprehensive pragmatic cluster randomised trial will be conducted in 11 RACFs – Western Australia and the estimated number of residents within these facilities is approximately 409-439 residents. This study aims to evaluate the pattern of use of psychotropic drugs by residents of RACFs before and after an educational intervention program. The educational intervention will be implemented by DTA staff over 3 to 6 months. All the clusters will provide baseline data on entry into the study. • Sub-study. (n= 56) Quality of Life (QoL) Measures: QoL was assessed by the self-reported Quality of Life in Alzheimer’s Disease (QoL-AD), neuropsychiatric symptoms and staff distress by Neuropsychiatric Inventory–Questionnaire version (NPI-Q), cognition by Standardised Mini-Mental State Examination (SMMSE) and activity of daily living assessment by Bristol Activity of Daily Living Scale (BADLS). Medication data were obtained from residents’ medication charts. Repeated assessments of all the above variables were performed at 6 and 12 months. All participants are voluntary, and they can withdraw at any time without any reason. The researcher will first arrange consent with the residential aged care facility (RACF), then participants will be either consented to be part of the study or a proxy (a close family member) will provide consent on their behalf if the participant has moderate to severe cognitive impairment and is unable to provide consent. • Firstly, the recruited nursing home will send an email to the residents’ relatives/families to inform them about the research project. Those persons/families who indicate an interest will be contacted by the researcher who will provide them with the project’s Information Sheet and consent form to participate. The participant will also consent, if they have capacity, or if they do not have capacity to consent, they will provide assent. In those participants who lack capacity to consent, consent will be provided by a proxy decision maker (a close family member, next of kin). •Participants who agreed to participate in this research, will complete QoL survey. Then, the carer will complete the Neuropsychiatric Inventory (NPI), and Bristol Activities of Daily Living Scale for the participants. This survey will be administered at the baseline, 3-6 months post the intervention. •The de- Identifiable data (anonymous) will be also collected from RACFs regarding (psychotropics, antipsychotics and benzodiazepines) at baseline, 6 months post intervention and follow-up at 12 months