Psychotropic Medications and the Transition Into Care: A National Data Linkage Study

Maguire, Aideen; Hughes, Carmel; Cardwell, Christopher; O’Reilly, Dermot

doi:10.1111/jgs.12101

Cited by 40 publications

(44 citation statements)

References 30 publications

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“…27,35 This study's observation that 12.1% of people ≥65 years old were prescribed one or more B&Zs, that is, one in four of the care home population and one in nine of the non-care home residents, with care home residents approximately three times more likely to have a B&Z prescribed, is also comparable to the wider literature, 2,25,[27][28][29]37 but is lower than that found among a Canadian sample. 1 This study found anxiolytic prescribing for non-care home residents to be comparable with previous studies.…”

Section: Comparison With Existing Literaturesupporting

confidence: 63%

“…1 This study found anxiolytic prescribing for non-care home residents to be comparable with previous studies. 27,35,37 However, for care home residents it was almost twice as high as previously reported. 27,35 Hypnotic prescribing was also comparable with previous studies for non-care home residents, 27,35 and with care home residents in one study, 27 but significantly lower than the 26.6% observed in another study.…”

Section: Comparison With Existing Literaturementioning

confidence: 46%

“…However, more personalised data are available for health boards and approved researchers. As with other studies of this nature, the lack of information on drug indications linked to prescribing is a limiting factor, 1,2,[27][28][29]35 but details of prescription indications in patients' clinical notes are known to be incomplete or lacking. 24 This may improve with the introduction of the Scottish Primary Care Resource (SPIRE), a collaboration between the Scottish Government and NHS National Services Scotland to simplify and standardise the process for extracting data from GP practice systems for audit, disease surveillance, benchmarking, planning, and research.…”

Section: 3 Lormetazepam (S) or Zaleplon (S)mentioning

confidence: 99%

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Benzodiazepine and z-hypnotic prescribing for older people in primary care: a cross-sectional population-based study

et al. 2016

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Background Overall prescribing of benzodiazepines and z-hypnotics (B&Zs) has slowly reduced over the past 20 years. However, long-term prescribing still occurs, particularly among older people, and this is at odds with prescribing guidance. Aim To compare prescribing of B&Zs between care home and non-care home residents ≥65 years old. Design and setting Cross-sectional population-based study in primary care in Scotland. Method National patient-level B&Z prescribing data, for all adults aged ≥65 years, were extracted from the Prescribing Information System (PIS) for the calendar year 2011. The PIS gives access to data for all NHS prescriptions dispensed in primary care in Scotland. Data were stratified by health board, residential status, sex, and age (65–74, 75–84, and ≥85 years). To minimise disclosure risk, data from smaller health boards were amalgamated according to geography, thereby reducing the number from 14 to 10 areas. Results A total of 17% (n= 879 492) of the Scottish population were aged ≥65 years, of which 3.7% (n= 32 368) were care home residents. In total, 12.1% (n= 106 412) of older people were prescribed one or more B&Z: 5.9% an anxiolytic, 7.5% a hypnotic, and 1.3% were prescribed both. B&Zs were prescribed to 28.4% (9199) of care home and 11.5% (97 213) of non-care home residents (relative risk = 2.88, 95% CI = 2.82 to 2.95,P<0.001). Estimated annual B&Z exposure reduced with increasing age of care home residents, whereas non-care home residents’ exposure increased with age. Conclusion B&Zs were commonly prescribed for older people, with care home residents approximately three times more likely to be prescribed B&Zs than non-care home residents. However, overall B&Z exposure among non-care home residents was found to rise with increasing age

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Section: Comparison With Existing Literaturesupporting

confidence: 63%

Section: Comparison With Existing Literaturementioning

confidence: 46%

Section: 3 Lormetazepam (S) or Zaleplon (S)mentioning

confidence: 99%

See 1 more Smart Citation

Benzodiazepine and z-hypnotic prescribing for older people in primary care: a cross-sectional population-based study

et al. 2016

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“…an electronic record of all prescriptions provided by a General Practitioner and dispensed in 44 community pharmacies in Northern Ireland from 2008 onwards (Maguire et al, 2013). Northern 45…”

Section: Area Characteristics 40mentioning

confidence: 99%

Does conurbation affect the risk of poor mental health? A population based record linkage study

Maguire

O’Reilly

2015

Health & Place

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“…2 It has been reported that the prescription rates of antipsychotics were higher in LTCF residents than in community dwellers. 7,9 One study reported that approximately 80% of dementia patients placed in LTCFs exhibit BPSD. 10 The trend in Korea shows an increasing number of dementia patients placed in LTCFs nationwide, 11 and it highlights the growing need for appropriate BPSD management.…”

Section: Introductionmentioning

confidence: 99%

Factors correlated with initiating antipsychotics among dementia patients in Korean long-term care facilities: National Health Insurance Service-Senior Cohort (2002-2013)

2017

JCGG

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Background/Objectives: This study aimed to identify the pattern of initial antipsychotic prescriptions among dementia patients in Korean long-term care facilities (LTCFs), despite safety issues, and to investigate various factors correlated with their use. Methods: We used a population-based senior cohort database of the Korean National Health Insurance Service (2002Service ( -2013 to target dementia patients newly admitted to LTCFs with no history of schizophrenia or bipolar disorder, and no history of antipsychotic use within six months prior to institutionalization (N=1,986). The sociodemographic, clinical, and facility-related characteristics were compared between the antipsychotic prescription and non-prescription groups. We used multivariate logistic regression models to identify factors that may affect the prescription of antipsychotics. Results: The mean initial prescription rate of antipsychotics was 38.1%. A higher prescription rate of antipsychotics during institutionalization was correlated with male gender, use of memantine, schizophrenia, bipolar disorder, sleep disorder, depression, anxiety disorder, a greater number of pre-admission BPSD, and lower pre-admission functional dependence. A total of 59.4% of cases with antipsychotic prescriptions presented with psychotic symptoms, aggression, and agitation, of which 20.8%, and 19.8% presented with other behavioral and psychological symptoms of dementia (BPSD), and no BPSD, respectively. Conclusions: The rate of initial antipsychotic prescriptions in Korean LTCF residents with dementia was high, and the prescription of antipsychotics was more strongly affected by the clinical characteristics of the patients than by sociodemographic or facility-related factors. Notably, more than 40% of the dementia patients in LTCFs received antipsychotics without appropriate indications.

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Psychotropic Medications and the Transition Into Care: A National Data Linkage Study

Cited by 40 publications

References 30 publications

Benzodiazepine and z-hypnotic prescribing for older people in primary care: a cross-sectional population-based study

Benzodiazepine and z-hypnotic prescribing for older people in primary care: a cross-sectional population-based study

Does conurbation affect the risk of poor mental health? A population based record linkage study

Factors correlated with initiating antipsychotics among dementia patients in Korean long-term care facilities: National Health Insurance Service-Senior Cohort (2002-2013)

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