Psychotropic drug use in Sydney nursing homes

Snowdon, John; Vaughan, Rosemary; Miller, Robert J.; Burgess, Emma; Tremlett, Pamela

doi:10.5694/j.1326-5377.1995.tb126117.x

Cited by 50 publications

(28 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Twenty-four percent of these patients were taking neuroleptics, and of these, 88% were receiving neuroleptics inappropriately according to the Omnibus Budget Reconciliation Act (OBRA) guidelines. This figure is similar to the 20% to 50% incidence of antipsychotic medication use reported in the United States (Shorr et al, 1994) and the 27% incidence in Sydney, Australia (Snowdon et al, 1995). Passmore and colleagues (1995) found that 19% of nursing home residents in North and West Belfast, Ireland, were taking phenothiazines.…”

supporting

confidence: 75%

Regulatory Issues Concerning Behavioral and Psychological Symptoms of Dementia in Europe

McKeith¹

2000

Int. Psychogeriatr.

View full text Add to dashboard Cite

In 1995, a new European system for the authorization of medicinal products went into effect. After 10 years of cooperation between National Registration Authorities at the European Union (EU) level and 4 years of negotiation, in June 1993 the Council of the EU adopted three directives and a regulation that together form the legal basis of the current system. The European Medicines Evaluation Agency (EMEA) was established on July 22, 1993, and London was chosen as its coordinating center, housing the Committee for Proprietary Medicinal Products (CPMP), which is the body that advises the European Licensing Authority (European Commission). The EMEA has the opportunity to harness the expertise and resources of member states and their ability to oversee local implementation.

show abstract

supporting

confidence: 75%

Regulatory Issues Concerning Behavioral and Psychological Symptoms of Dementia in Europe

McKeith¹

2000

Int. Psychogeriatr.

View full text Add to dashboard Cite

show abstract

“…Two of these studies have not separated dementia patients from other nursing home patients (Brodaty et al, 2001, Margallo-Lana et al, 2001 and in the remaining one, the approach to behavioral symptoms has not been as comprehensive as in community studies (Sourial et al, 2001). In addition, there are a number of studies describing the use of psychotropic drugs among all nursing homes residents (Avorn et al, 1989;Conn et al, 1999;Snowdon, 1999;Draper et al, 2001, Ruths et al, 2001, but few studies on how specifically, patients with dementia in institutional settings are treated with psychotropic drugs (Lasser and Sunderland, 1998). Therefore, the aim of our study was to describe the prevalence of various psychiatric and behavioral symptoms in patients with dementia in nursing homes and acute geriatric wards.…”

Section: Introductionmentioning

confidence: 96%

Behavioral symptoms and the administration of psychotropic drugs to aged patients with dementia in nursing homes and in acute geriatric wards

Pitkälä

Laurila

Strandberg

et al. 2004

Int. Psychogeriatr.

View full text Add to dashboard Cite

Objectives:To describe the prevalence of various psychiatric and behavioral symptoms among patients with dementia in nursing homes and acute geriatric wards and to investigate the administration of psychotropic medications to these patients.Methods: 425 consecutive patients (>70 years) in six acute geriatric wards in two city hospitals and seven nursing homes in Helsinki, Finland, were assessed with an extensive interview, cognitive tests, and attention tests. Of these, 255 were judged to have dementia according to the following information: previous dementia diagnoses and their adequacy, results of CT scans, Mini-mental State Examination (MMSE) tests, Clinical Dementia Scale (CDR) tests, and DSM-IV criteria. Psychiatric and behavioral symptoms were recorded over two weeks for each patient.Results: Psychiatric and behavioral symptoms were very common among patients with dementia in both settings. In all, 48% presented with psychotic symptoms (delusions, visual or auditory hallucinations, misidentifications or paranoid symptoms), 43% with depression, 26% agitation, and 26% apathy. Use of psychotropic drugs was also common: 87% were on at least one psychotropic drug, 66% took at least two, 36% at least three, and 11% four or more psychotropic drugs. Of the patients with dementia, 42% were on conventional antipsychotics, and 34% on anxiolytics despite their known side-effects. Only 13% were on atypical antipsychotics and 3% on cholinesterase inhibitors. The K. H. Pitkala et al.use of selective serotonin reuptake inhibitors (SSRIs) was common (31%) among the patients. A surprising finding was that drugs with anticholinergic effects were also frequently (20%) used. Conclusion:Both behavioural symptoms and use of psychotropic drugs are very common among dementia patients in institutional settings. The frequent use of potentially harmful drugs implies a need for education among physicians taking care of these patients.

show abstract

“…Die Beurteilung der Verhaltensauffälligkeiten erfolgte in diesem Fragebogen in Anlehnung an die Cambridge Mental Disorder of the Elderly Examination (14). Die Bewertung der baulicharchitektonischen Rahmenbedingungen sowie die personelle Ausstattung der Heime wurde auf Grundlage des SIESTA, einem standardisierten Instrumentarium zur Evaluation von Einrichtungen der stationären Altenhilfe (3) (5,15,21). Vergleicht man den Psychopharmakagebrauch in den einzelnen Heimen, so ergeben sich signifikante Unterschiede.…”

Section: Methode N Stichprobeunclassified

“…Ein hoher Verbrauch von Arzneimitteln, speziell von psychotropen Substanzen ist dabei nicht überraschend. So liegen in internationalen Arbeiten die Verordnungsraten von Psychopharmaka bei Heimbewohnern zwischen 34 und 75% (8,(15)(16)(17). Erhebungen in der Bundesrepublik Deutschland ergaben bei Altenheimbewohnern einen Anteil von 42,1-47,6%, bei Altenpflegeheimbewohnern von 58,5% (5,19,21).…”

Section: Originalarbeit Einleitungunclassified

“…Einige Autoren gehen davon aus, dass die hohe Prävalenz psychischer Störungen, oft verbunden mit Verhaltensauffälligkeiten der Bewohner, nicht der einzige Grund für den hohen Psychopharmakagebrauch in Heimen ist. So wurden Zusammenhänge zwischen personellen und räumlichen Bedingungen der Pflegeeinrichtungen und der Gabe psychoaktiver Medikamente gefunden (2,4,15,17). Besonders über mögliche Zusammenhänge zwischen dem Psychopharmakagebrauch einerseits und den institutionellen Rahmenbedingungen sowie den individuellen Merkmalen der Alten-und Altenpflegeheimbewohner andererseits ist bisher nur sehr wenig bekannt.…”

Section: Originalarbeit Einleitungunclassified

See 1 more Smart Citation

Determinanten des Psychopharmakagebrauchs in Alten- und Altenpflegeheimen

Stelzner¹,

Riedel-Heller

Sonntag

et al. 2001

Zeitschrift f�r Gerontologie und Geriatrie

View full text Add to dashboard Cite

A large proportion of the residential and nursing home population is mentally ill. The causes for increased prescription of psychotropic drugs other than mental disorders have been discussed. This study presents data on the role of the individual's characteristics and institutional conditions on psychotropic drug use in residents of residential and nursing homes. Therefore the psychotropic drug use of 4 old-people's homes in Leipzig (Germany) was reviewed. Sociodemographic characteristics and a number of behavioral patterns of the residents were examined. Regression analysis revealed associations of age, gender and certain behavioral patterns (e.g., agitation, insomnia with nightly disturbances) and psychotropic drug use. Beyond that, psychotropic drug use varied among the 4 institutions' practices. Further research should be aimed at gaining insight into the interplay of these individual and institutional influences on psychotropic drug use in order to develop specific interventions to optimize treatment.

show abstract

Psychotropic drug use in Sydney nursing homes

Cited by 50 publications

References 22 publications

Regulatory Issues Concerning Behavioral and Psychological Symptoms of Dementia in Europe

Regulatory Issues Concerning Behavioral and Psychological Symptoms of Dementia in Europe

Behavioral symptoms and the administration of psychotropic drugs to aged patients with dementia in nursing homes and in acute geriatric wards

Determinanten des Psychopharmakagebrauchs in Alten- und Altenpflegeheimen

Contact Info

Product

Resources

About