Psychotropic medication use among elderly nursing home residents in Slovenia: cross-sectional study

Šter, Marija Petek; Gorup, Eva Cedilnik

doi:10.3325/cmj.2011.52.16

Cited by 25 publications

(23 citation statements)

References 36 publications

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“…Our data compare well with recently published data from nursing homes [ 5 , 24 , 25 ]. Residents in nursing homes, particularly those with dementia, often receive psychotropic drugs, among these even a high percentage of neuroleptics which may shorten their lives [ 1 – 4 , 6 – 8 ].…”

Section: Discussionsupporting

confidence: 90%

High prevalence of prescription of psychotropic drugs for older patients in a general hospital

Arnold

Straube

Himmel

et al. 2017

BMC Pharmacol Toxicol

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BackgroundMany elderly patients receive psychotropic drugs. Treatment with psychotropic agents is associated with serious side effects including an increased risk of falls and fractures. Several psychotropic drugs are considered potentially inappropriate for treatment of the elderly.MethodsA retrospective chart review was conducted covering all patients aged ≥ 65 years who were admitted to Evangelisches Krankenhaus Göttingen-Weende between 01/01/2013 and 03/31/2013. Psychotropic drugs reviewed for included benzodiazepines, Z-drugs, antidepressants and neuroleptics, but not drugs for sedation during artificial ventilation or pre-medication before surgery. Potentially inappropriate drugs were identified according to the PRISCUS list. To assess which factors were associated with the administration of psychotropic drugs, univariate and multivariable logistic regression analyses were performed.ResultsThe charts of 2130 patients (1231 women) were analyzed. 53.9% of all patients received at least one psychotropic medication (29.5% benzodiazepines, 12.6% Z-drugs, 22.2% antidepressants, 11.9% neuroleptics). The mean number of psychotropic drugs prescribed per patient with at least one prescription was 1.6. Patients treated in the geriatric department most often received antidepressants (45.0%), neuroleptics (20.6%) and Z-drugs (27.5%). Benzodiazepines and Z-drugs were prescribed mostly as medication on demand (77.7% of benzodiazepines, 73.9% of Z-drugs). Surgical patients most frequently received benzodiazepines (37.1%). Nearly one-third of all patients ≥ 65 years was treated with at least one potentially inappropriate psychotropic medication. The mean number of potentially inappropriate psychotropic medications per patient with at least one psychotropic prescription was 0.69. The percentage of patients with potentially inappropriate psychotropic medication was highest in the surgical departments (74.1%). Female gender (adjusted OR 1.36; 95% CI 1.14 to 1.63), stay in the Department of Geriatrics (2.69; 2.01 to 3.60) or the interdisciplinary intensive care unit (1.87; 1.33 to 2.64) and age ≥ 85 years (1.33; 1.10 to 1.60) were associated with psychotropic drug treatment.ConclusionsA high percentage of patients aged ≥ 65 years received psychotropic drugs. The chance that a potentially inappropriate psychotropic drug would be administered was highest in the surgical departments. Antidepressants, neuroleptics and Z-drugs were used surprisingly often in geriatric medicine. Educational strategies could reduce the use of psychotropic drugs and the prescription of potentially inappropriate medications.

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Section: Discussionsupporting

confidence: 90%

High prevalence of prescription of psychotropic drugs for older patients in a general hospital

Arnold

Straube

Himmel

et al. 2017

BMC Pharmacol Toxicol

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“…The prevalence of psychotropic medication use among the elderly is high [ 34 , 35 ], with a reported prevalence of up to 73% in subjects aged 65 years and over [ 34 ]. Use of psychotropic medications except benzodiazepines has been found to be associated with an increased risk of dementia [ 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Benzodiazepine Use and Dementia: A Meta-Analysis

et al. 2015

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BackgroundThe association between long-term benzodiazepine use and risk of dementia remains controversial. Therefore, current study aimed to quantify this association, and to explore a potential dose–response pattern.MethodsWe searched PubMed, Embase and the Cochrane Library through August 17, 2014. We included nested case-control or prospective cohort studies that provided risk estimates on the association of benzodiazepine use with risk of dementia, and a clear definition of status of benzodiazepine use. Overall effect size was calculated using a random-effects model.FindingsSix studies were eligible for inclusion, involving 11,891 dementia cases and 45,391 participants. Compared with never users, pooled adjusted risk ratios (RRs) for dementia were 1.49 (95% confidence interval (CI) 1.30–1.72) for ever users, 1.55 (95% CI 1.31–1.83) for recent users, and 1.55 (95% CI 1.17–2.03) for past users. The risk of dementia increased by 22% for every additional 20 defined daily dose per year (RR, 1.22, 95%CI 1.18–1.25). When we restricted our meta-analyses to unadjusted RRs, all initial significant associations persisted.ConclusionsLong-term benzodiazepine users have an increased risk of dementia compared with never users. However, findings from our study should be treated with caution due to limited studies and potential reverse causation. Large prospective cohort studies with long follow-up duration are warranted to confirm these findings.

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“…The use of psychotropic drugs in European nursing homes is reported to be quite frequent (Petek Šter and Cedilnik Gorup, 2011;Mann et al, 2013). Moreover, anxiety and the use of anxiolytics are frequently reported among nursing home residents (Seitz et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Mental Health, Quality of Life and Medication Use Among Care Home Residents and Community Dwelling Older People

O’Neill¹,

Ryan²,

Slater³

et al. 2019

International Journal of Research in Nursing

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In most countries, the prevalence of depression in care homes is substantially higher than among community-dwelling older people. Negative media reports and the stigma associated with long-term care perpetuates the belief that community care is associated with a better quality of life than nursing or residential home care. The aim of this paper is to investigate mental health, quality of life and medication use among a sample of care home residents and community dwelling older people. This cross-sectional study comprised of structured interviews with 75 care home residents and 852 community dwelling older adults in a large health and social care trust within the U.K. Data were collected using an abridged version of the World Mental Health-Composite International Diagnostic Interview (WMH-CIDI). Health-related quality of life was assessed using the SF-6D, derived from responses to the SF-12, which was embedded within the screening section of the WMH-CIDI. Results showed a significantly lower level of mental disorders among older people in the care home sample. Health-related quality of life results indicated that although care home participants were significantly more limited in their physical functioning, they reported better mental health and social functioning than older people living in the community. These results were statistically significant. Prescription rates for mental health medication were higher in the care home sample. This study provides tentative findings about mental health and quality of life in care homes, which should be further explored in future research. The study addresses the negative public perception of quality of life in care homes while contributing to the debate around the health care implications of 'ageing in place' for older people. There is a need to address the relationship between mental health, quality of life and medication use among older people across a range of care settings.

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Psychotropic medication use among elderly nursing home residents in Slovenia: cross-sectional study

Cited by 25 publications

References 36 publications

High prevalence of prescription of psychotropic drugs for older patients in a general hospital

High prevalence of prescription of psychotropic drugs for older patients in a general hospital

Association between Benzodiazepine Use and Dementia: A Meta-Analysis

Mental Health, Quality of Life and Medication Use Among Care Home Residents and Community Dwelling Older People

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