Variations and factors associated with psychotropic use in cognitively impaired elderly residing in long‐term care facilities in East Asia: a cross‐sectional study

Abstract

Background The aim of this cross‐sectional study was to compare patterns of psychotropic prescription drug use among cognitively impaired residents in long‐term care facilities in East Asia and to explore factors associated with these patterns. Methods This study included elderly participants with cognitive impairments residing in long‐term care facilities with and without dementia care units in Japan, South Korea, China, Taiwan, and Thailand. The Mini‐Mental State Examination, the Clinical Dementia Rating, and the Neuropsychiatric Inventory, Nursing Home version were used to assess cognitive status, examine dementia severity, and evaluate behavioural psychological symptoms of dementia, respectively. The rate of psychotropic drug use and the relationship between the number of psychotropic drugs and clinical factors were examined. Results In total, 662 people were analyzed. Facilities with dementia care units had a higher rate of anti‐dementia drug use than regular elderly care sites. Among the three dementia care sites, a Japanese hospital and a Korean site had a high rate of antipsychotic use and use of other types of psychotropics, whereas these drugs were used at a low rate in a Chinese nursing home. Patterns of psychotropic drug use may be partially associated with local regulations and facility type. Poly‐pharmacy was identified as a common problem at all study sites. Conclusions Our findings will be beneficial for health‐care professionals and policymakers when developing practice guidelines and strategies to regulate overuse of psychotropics and poly‐pharmacy. Prospective studies are needed to examine patterns of psychotropic prescriptions and to promote evidence‐based practice.

Prevalence of incontinence among cognitively impaired older residents in long‐term care facilities in East Asia: A cross‐sectional study

“…Medication was not adjusted, because a high proportion of the sample was prescribed medications. 18 The JMP version 12 software package (SAS Institute, Cary, NC, USA) was used for statistical analysis. P < 0.05 was considered to be significant.…”

“…Details on the data collection methods were published elsewhere . We chose a variety of LTCF in the present study, because they represent typical settings in East Asia for extended care of people with cognitive impairment.…”

“…A bivariate analysis was carried out between the dependent variables and independent variables, and independent variables showing statistically significant associations with the dependent variables were entered into the regression model. Medication was not adjusted, because a high proportion of the sample was prescribed medications . The jmp version 12 software package (SAS Institute, Cary, NC, USA) was used for statistical analysis.…”

“…The present study was part of the Prevalence of Symptoms of Dementia in East Asian Cross‐cultural study, which examined the type and prevalence of behavioral and psychological symptoms of dementia in East Asian countries . Cross‐sectional data were collected between September 2015 and April 2016 from seven study sites in East Asia, including Japan, Korea, China, Taiwan and Thailand.…”

“…Details on the data collection methods were published elsewhere. 18 We chose a variety of LTCF in the present study, because they represent typical settings in East Asia for extended care of people with cognitive impairment. In Japan, the following three types of dementia facilities were selected: the dementia care ward at a general hospital, group homes (Japan-GH) and LTCF (Japan-LTCF).…”