The "CHROME criteria": Tool to optimize and audit prescription quality of psychotropic medications in institutionalized people with dementia

Describe and validate the CHROME (CHemical Restraints avOidance MEthodology) criteria. Observational prospective longitudinal study. Single nursing home in Las Palmas de Gran Canaria, Spain. 288 residents; mean age: 81.6 (SD 10.6). 77.4% had dementia. Multicomponent training and consultancy program to eliminate physical and chemical restraints and promote overall quality care. Clinicians were trained in stringent diagnostic criteria of neuropsychiatric syndromes and adequate psychotropic prescription. Psychotropic prescription (primary study target), neuropsychiatric syndromes, physical restraints, falls, and emergency room visits were semi-annually collected from December 2015 to December 2017. Results are presented for all residents and for those who had dementia and participated in the five study waves (completer analysis, n=107). For the study completers, atypical neuroleptic prescription dropped from 42.7% to 18.7%, long half-life benzodiazepines dropped from 25.2% to 6.5%, and hypnotic medications from 47.7% to 12.1% (p