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Prescribing pattern of psychotropic drugs in nursing home residents with dementia

Published online by Cambridge University Press:  20 June 2011

R. B. Wetzels ,
S. U. Zuidema ,
J. F. M. de Jonghe ,
F. R. J. Verhey  and
R. T. C. M. Koopmans
R. B. Wetzels*
Affiliation:
Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands Care Center Rivierenland Foundation, Tiel, the Netherlands
S. U. Zuidema
Affiliation:
Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
J. F. M. de Jonghe
Affiliation:
Geriatric Medicine, Medical Center Alkmaar, Alkmaar, the Netherlands
F. R. J. Verhey
Affiliation:
Alzheimer Center Limburg/Institute of Mental Health and Neurosciences, Maastricht UMC, Maastricht, the Netherlands
R. T. C. M. Koopmans
Affiliation:
Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
*
Correspondence should be addressed to: Roland B. Wetzels, MD, Radboud University Nijmegen, Medical Centre, Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Code 117 ELG, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands. Phone: +31-24-3618834; Fax: +31-24-3619558. Email: r.wetzels@elg.umcn.nl.
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Abstract

Background: The goal of this study is to determine patterns of psychotropic drug use (PDU), the association with neuropsychiatric symptoms (NPS), and the variability across dementia types in nursing home residents with dementia. In addition, PDU was analyzed across multiple indications.

Methods: This was a prospective cohort study over a two-year period from 2006 to 2008, which involved 14 dementia special care units in nine nursing homes. A total of 117 residents with dementia participated in the study, of whom 35% had Alzheimer's dementia (AD) and 11% vascular dementia (VaD). PDU was classified according to anatomical therapeutic chemical-classification as either “present” or “absent”.

Results: The majority of residents had moderately severe to severe dementia. At all successive assessments, almost two-thirds of residents received any psychotropic drug (PD) and almost one-third continued to receive any PD. Of all PDs, antipsychotics (APs) were prescribed most frequently. Fewer residents started with antidepressants, but continued to receive antidepressants at higher percentages. Anxiolytics showed an intermittent course, but a subgroup of 9% showed two-year continuation. Once started on PDs at baseline, residents continued to use PDs at high percentages: three-quarters continued to receive APs for at least six months. Half of residents received at least one PD; one-fifth received at least two PDs simultaneously. Residents with AD received more hypnotics and antidementia drugs; residents with VaD received more antipsychotics, antidepressants, anxiolytics and anticonvulsants.

Conclusions: PDs have different utilization patterns, but overall, consistently high continuation rates were found. These results warrant scrutiny of continuous PDU.

Keywords

persistencehigh prescription ratedifferent patterns of prescription
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 8 , October 2011 , pp. 1249 - 1259
Copyright
Copyright © International Psychogeriatric Association 2011

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