Consumption of psychotropic drugs in nursing home residents: A prospective study in patients permanently admitted to a nursing home

Abstract

A. VOLLSET SUMMARYIn a prospective study, the routine handling of psychotropic drugs in five nursing homes in Bergen, Norway, was examined in patients who were admitted to a permanent stay. A follow-up was performed after 3 months. Of the 83 patients who were admitted 64% consumed psychotropic drugs, at follow-up 68%. Both at admittance and after 3 months one-third of the residents were treated with antipsychotics. For antipsychotics alone evident changes were observed during the observation time. The consumers were more liable to be demented, restless and wandering, The study confirms the high number of residents using psychotropic drugs. It is concluded that 'overprescription' seems to be a general way of treating disruptive behaviour and not confined to nursing homes.

Psychotropic drug use in elderly people with and without dementia

“…In this study, both study periods showed that persons with dementia used psychotropic drugs more than persons without dementia, similar to a previous study which found higher psychotropic drug use by cognitively impaired elderly than by subjects who were cognitively intact (Nygaard et al, 1994;Hanlon et al, 1996). The role of psychotropic drugs in the presence of a dementing illness is problematic.…”

“…Earlier studies comparing psychotropic drug use between elderly persons with and without dementia included nursing home residents with subjects younger than 65, and a population-based study on non agenarians (Nygaard et al, 1994;Forsell and Winblad, 1997).…”

Concealment of drugs in food and beverages in nursing homes: cross sectional study

“…A Swedish study showed that the quality assurance of drug administration was positively associated with the quality of the communication between the physician and the nurses, and was higher in nursing homes where discussions about drug treatment took place in the multidisciplinary team 22. Nygaard et al have reported that in nursing homes with a full time physician the use of antipsychotic drugs is lower than in nursing homes where a physician works part time 23. Even though these two studies did not include covert administration, the importance of an interested physician, cooperating with other health personnel in the nursing home to reduce the use of covert administration, might be substantial.…”

Difficult behaviour and dementia in nursing homes: five cases of psychosocial intervention

“…This is despite concerns about over-prescription (Nygaard et al, 1994); potential addiction, dependence and adverse side effects (Solomon, Shackson, & Brown, 1995;Gash and Chhabra, 1996); their possible misuse (Ray, Federspiel, & Schaffner, 1980;Hesse, Driscoll, & Jacobson, 1993); their association with increased cognitive decline or 'sensitivity' and poorer wellbeing (Holmes, Fortenza, Powell, & Lovestone, 1997;McShane et al, 1997;Ballard, Grace, McKeith, & Holmes, 1998;Ballard et al, 2001b); an increased risk of falls (Cooper, 1994); the restricted nature of their efficacy (Barnes, Veith, Okimoto, Raskind, & Gumbrecht, 1982;Schneider, Pollock, & Lyness, 1990;Bridges-Parlet, Knopman, & Steffes, 1997;Ballard et al, 2001a) and the strong case for behavioural and environmental intervention prior to resorting to medication (Murphy, 1989;Herrmann, Lanct O ot, & Naranjo, 1996;Howard, Ballard, O'Brien, & Burns, 2001).…”