Geriatric drug utilisation of psychotropics in Belgian nursing homes

Azermai, Majda; Elseviers, Monique; Petrovic, Mirko; Bortel, Lucas Van; Stichele, Robert Vander

doi:10.1002/hup.1160

Cited by 78 publications

(64 citation statements)

References 31 publications

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“…We did not assess in detail the effects of psychotropic drugs on BPSD, as this is not a pharmacological study. Furthermore, psychotropic drug intake rates vary among countries and Belgium is known to have a high prevalence of psychotropic drug utilization in communitydwelling elderly and nursing home residents (Azermai, Elseviers, Petrovic, Van Bortel, & Vander Stichele, 2011). This also partially explains the high prevalence of psychotropic drug intake in MCI and AD patients in this study.…”

Section: Discussionmentioning

confidence: 72%

Psychosis associated behavioral and psychological signs and symptoms in mild cognitive impairment and Alzheimer's dementia

Mussele

Mariën

Saerens

et al. 2014

Aging & Mental Health

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Section: Discussionmentioning

confidence: 72%

Psychosis associated behavioral and psychological signs and symptoms in mild cognitive impairment and Alzheimer's dementia

Mussele

Mariën

Saerens

et al. 2014

Aging & Mental Health

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“…The concomitant prescribing of more than one CNS medication is common in aged care homes [58,59,60,61,62,63,64,65,66,67]. This is a matter of concern, as combinations could lead to adverse outcomes.…”

Section: Discussionmentioning

confidence: 99%

An Evaluation of the Central Nervous System Medication Use and Frailty among Residents of Aged Care Homes in Malaysia

et al. 2017

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Background/Aims: Old age and institutionalization in care homes are associated with increased use of risk medications affecting the central nervous system (CNS). This study evaluated medication utilization and appropriateness; and assessed frailty among residents of Malaysian aged care homes. Methods: The subjects of this study included 202 elderly (≥65 years) residents of 17 aged care homes in suburban peninsular Malaysia. Frailty was measured using the Groningen Frailty Indicator (GFI) score and independence in daily living was measured as KATZ activity of daily living score. Medication appropriateness was assessed using the Medication Appropriateness Index (MAI) and 2015 Beers' criteria for Potentially Inappropriate Medication (PIM). Results: CNS medications constituted about 16% of the total, with an average of 0.8 ± 1.1 medications per resident, which reduced to 0.5 ± 0.8 medications after 3 months. Frailty (154/202) and polypharmacy (90/202) were highly prevalent in study subjects.Subjects on CNS medications had significantly higher GFI score (7.1 vs. 5.9; p = 0.031), polypharmacy (57.8 vs. 35.3%; p = 0.002), number of PIMs (0.9 vs. 0.2; p = 0.001), and mean summed MAI score (3.6 vs. 2.6; p = 0.015) than subjects not on CNS medications. Medication number was also significantly correlated with GFI (r = 0.194; p = 0.006) and KATZ (r = 0.141; p = 0.046) scores. Conclusion: Frailty and polypharmacy were highly prevalent among aged care home subjects taking CNS medications. These findings support the notion that periodic regular medication review should improve the overall use of medications in elderly patients.

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“…Benzodiazepine utilisation in older adults is high, with intake rates varying from 28% to 55% in European nursing homes [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Benzodiazepine use in Belgian nursing homes: a closer look into indications and dosages

Bourgeois

Elseviers

Azermai

et al. 2011

Eur J Clin Pharmacol

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AIM:(i)To describe the prevalence of benzodiazepine use in Belgian nursing homes, with specific attention to indications and dosages.(ii)To compare actual and recommended dosages of benzodiazepines for anxiety and insomnia.(iii)To explore the risk profile for chronic benzodiazepine use in institutionalised older adults. METHODS:Medication charts of 1730 residents from 76 nursing homes in Belgium were collected and analysed, using the ATC classification. Drug name, indication and daily dosage were recorded. From authoritative international sources, we extracted for each drug and each indication a daily dosage recommended not to exceed in older adults, for comparison with observed actual dosages. RESULTS:Among the chronic BZD/Z users (50% of the residents), the leading indication was 'insomnia' (59% of the users) followed by 'anxiety' (17%) and 'unrest' (10%). In the chronic prescriptions of BZD/Zs indicated for insomnia, the actual daily dose exceeded the geriatric upper limit: with lormetazepam in 95% ,zolpidem in 82%, zopiclone in 78% and lorazepam in 35% of the prescriptions. In anxiety, daily doses also exceeded the limit but not to the same extend.Multivariate analysis showed BZD/Z use was positively associated with pain (OR 1.58 CI95% 1.27-1.97), constipation ) and depression (OR 1.68 CI95% 1.35-2.08). Residents with dementia were less likely of receiving a BZD/Z (OR 0.60 CI95% 0.48-0.74). CONCLUSION:Efforts to reduce the use of BZD/Zs in nursing homes should concentrate on insomnia, with interventions aimed to reduce too high prevalence of chronic use and too high daily dosages in this indication.3

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Geriatric drug utilisation of psychotropics in Belgian nursing homes

Cited by 78 publications

References 31 publications

Psychosis associated behavioral and psychological signs and symptoms in mild cognitive impairment and Alzheimer's dementia

Psychosis associated behavioral and psychological signs and symptoms in mild cognitive impairment and Alzheimer's dementia

An Evaluation of the Central Nervous System Medication Use and Frailty among Residents of Aged Care Homes in Malaysia

Benzodiazepine use in Belgian nursing homes: a closer look into indications and dosages

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