TY - JOUR
T1 - Psychotropic drug prescription for nursing home residents with dementia
T2 - prevalence and associations with non-resident-related factors
AU - Smeets, Claudia H.W.
AU - Gerritsen, Debby L.
AU - Zuidema, Sytse U.
AU - Teerenstra, Steven
AU - van der Spek, Klaas
AU - Smalbrugge, Martin
AU - Koopmans, Raymond T.C.M.
PY - 2018/9/2
Y1 - 2018/9/2
N2 - Objectives: To determine psychotropic drug prescription rates in nursing home residents with dementia and to identify associations with the so far understudied psychosocial non-resident-related factors. Method: A cross-sectional, observational, exploratory design as part of PROPER I (PRescription Optimization of Psychotropic drugs in Elderly nuRsing home patients with dementia). Participants were 559 nursing home residents with dementia, 25 physicians, and 112 nurses in the Netherlands. Psychotropic drug prescription, non-resident-related and known resident-related variables were measured to operationalize the themes of our previous qualitative analysis. Results: Fifty-six percent of residents were prescribed any psychotropic drug, 25% antipsychotics, 29% antidepressants, 15% anxiolytics, and 13% hypnotics, with large differences between the units. Multivariate multilevel regression analyses revealed that antipsychotic prescription was less likely with higher physicians’ availability (odds ratio 0.96, 95% confidence interval 0.93–1.00) and that antidepressant prescription was more likely with higher satisfaction of nurses on resident contact (odds ratio 1.50, 95% confidence interval 1.00–2.25). Resident-related factors explained 6%–15% of the variance, resident- and non-resident-related factors together 8%–17%. Conclusion: Prescription rates for antipsychotics are similar compared to other countries, and relatively low for antidepressants, anxiolytics, and hypnotics. Our findings indicate that improvement of prescribing could provisionally best be targeted at resident-related factors.
AB - Objectives: To determine psychotropic drug prescription rates in nursing home residents with dementia and to identify associations with the so far understudied psychosocial non-resident-related factors. Method: A cross-sectional, observational, exploratory design as part of PROPER I (PRescription Optimization of Psychotropic drugs in Elderly nuRsing home patients with dementia). Participants were 559 nursing home residents with dementia, 25 physicians, and 112 nurses in the Netherlands. Psychotropic drug prescription, non-resident-related and known resident-related variables were measured to operationalize the themes of our previous qualitative analysis. Results: Fifty-six percent of residents were prescribed any psychotropic drug, 25% antipsychotics, 29% antidepressants, 15% anxiolytics, and 13% hypnotics, with large differences between the units. Multivariate multilevel regression analyses revealed that antipsychotic prescription was less likely with higher physicians’ availability (odds ratio 0.96, 95% confidence interval 0.93–1.00) and that antidepressant prescription was more likely with higher satisfaction of nurses on resident contact (odds ratio 1.50, 95% confidence interval 1.00–2.25). Resident-related factors explained 6%–15% of the variance, resident- and non-resident-related factors together 8%–17%. Conclusion: Prescription rates for antipsychotics are similar compared to other countries, and relatively low for antidepressants, anxiolytics, and hypnotics. Our findings indicate that improvement of prescribing could provisionally best be targeted at resident-related factors.
KW - Dementia
KW - nursing home
KW - psychotropics
UR - http://www.scopus.com/inward/record.url?scp=85025129642&partnerID=8YFLogxK
U2 - 10.1080/13607863.2017.1348469
DO - 10.1080/13607863.2017.1348469
M3 - Article
C2 - 28726490
AN - SCOPUS:85025129642
VL - 22
SP - 1239
EP - 1246
JO - Aging and Mental Health
JF - Aging and Mental Health
SN - 1360-7863
IS - 9
ER -