TY - JOUR
T1 - Use of antidepressant medications among older adults in European long-term care facilities: a cross-sectional analysis from the SHELTER study
AU - Giovannini, Silvia
AU - Onder, Graziano
AU - van der Roest, Henriëtte G.
AU - Topinkova, Eva
AU - Gindin, Jacob
AU - Cipriani, Maria Camilla
AU - Denkinger, Michael D.
AU - SHELTER Study Investigators
AU - Bernabei, Roberto
AU - Liperoti, Rosa
N1 - Funding Information:
Data for this cross-sectional study was obtained from the Services and Health for Elderly in Long TERm care (SHELTER) study, a project funded by Seventh Frame-work Programme of the European Union. Methodology of the SHELTER study is described in detail elsewhere [14]. The study was conducted during the years 2009 to 2011. Briefly, older adults residing in participating nursing homes at the beginning of the study and those admitted in the 3-month enrolment period following the initiation of the study were assessed using the interRAI instrument for Long-Term Care (interRAI LTCF) at baseline and reassessed at 6 and 12 months (follow-up assessments) if still residing in the facility. If no longer in the facility, reason (death, hospitalization, discharged to home or to another institution) and date of death or discharge were recorded. The only exclusion criterion was unwillingness to participate to the study. Study partners of the SHELTER project identified NHs willing to participate in the study. Patients residing in participating NHs at the initiation of the study and those who were admitted during the following 3-month period were assessed by use of the interRAI-LTCF tool. Overall, 4156 residents were included from 57 NHs across 7 European countries (10 NHs in the Czech Republic, 9 in England, 4 in Finland, 4 in France, 9 in Germany, 10 in Italy, 4 in The Netherlands) and 1 Non-European country (7 in Israel). The aim of the SHELTER study was to assess the use of the interRAI-LTCF, when translated into the languages of participating countries, as a tool to collect information about residents and to assess their care needs and the provision of care in NHs in EU countries. Over-all, 197 of the 198 the interRAI-LTCF items tested met or exceeded standard cut-offs for acceptable test-retest and inter-rater reliability [14].
Funding Information:
The SHELTER study was funded by the EU 7th Framework Programme The European Union support for the production of this study does not constitute an endorsement of the contents which reflects the views only of the authors. The European Union had no role in the design, methods, data collection, analysis and preparation of the manuscript.
Publisher Copyright:
© 2020 The Author(s).
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/8/27
Y1 - 2020/8/27
N2 - BACKGROUND: Late-life depression is common among older adults living in nursing homes (NHs). Over the last 30 years there has been an increase in the rates of prescription of antidepressant medications across all ages, with the largest rise reported in older adults. This study aimed to describe the pattern of antidepressant medication use among NH residents from 7 European countries and Israel and to examine patient and facilities characteristics that may account for it. METHODS: We conducted a cross-sectional analysis of data from the SHELTER study, an observational longitudinal cohort study that collected comprehensive resident data using the interRAI Long-Term Care Facility instrument in 7 European Countries and Israel. Descriptive statistics were used to examine sample characteristics. Potential correlates of antidepressant medication use were identified using multiple logistic regression modeling. RESULTS: Among 4023 residents entering the study, 32% had depressive symptoms and nearly half of these individuals used antidepressants. Antidepressant medication use varied by country, with a prevalence in the overall sample of 35.6% (n = 1431). Among antidepressant users, 59.9% were receiving selective serotonin reuptake inhibitors (SSRI). The strongest correlates of antidepressant use included reported diagnosis of anxiety, depression, bipolar disorder, pain, falls and high level of social engagement. Age over 85 years, living in facilities located in rural areas and a diagnosis of schizophrenia reduced the likelihood of being prescribed with an antidepressant. CONCLUSIONS: A large proportion of residents in European long-term care facilities receive antidepressant medications. The decision to prescribe antidepressants to NH residents seems to be influenced by both patient and facility characteristics. Future longitudinal studies should evaluate the efficacy and safety of antidepressant use in NHs thus providing evidence for recommendations for clinical practice.
AB - BACKGROUND: Late-life depression is common among older adults living in nursing homes (NHs). Over the last 30 years there has been an increase in the rates of prescription of antidepressant medications across all ages, with the largest rise reported in older adults. This study aimed to describe the pattern of antidepressant medication use among NH residents from 7 European countries and Israel and to examine patient and facilities characteristics that may account for it. METHODS: We conducted a cross-sectional analysis of data from the SHELTER study, an observational longitudinal cohort study that collected comprehensive resident data using the interRAI Long-Term Care Facility instrument in 7 European Countries and Israel. Descriptive statistics were used to examine sample characteristics. Potential correlates of antidepressant medication use were identified using multiple logistic regression modeling. RESULTS: Among 4023 residents entering the study, 32% had depressive symptoms and nearly half of these individuals used antidepressants. Antidepressant medication use varied by country, with a prevalence in the overall sample of 35.6% (n = 1431). Among antidepressant users, 59.9% were receiving selective serotonin reuptake inhibitors (SSRI). The strongest correlates of antidepressant use included reported diagnosis of anxiety, depression, bipolar disorder, pain, falls and high level of social engagement. Age over 85 years, living in facilities located in rural areas and a diagnosis of schizophrenia reduced the likelihood of being prescribed with an antidepressant. CONCLUSIONS: A large proportion of residents in European long-term care facilities receive antidepressant medications. The decision to prescribe antidepressants to NH residents seems to be influenced by both patient and facility characteristics. Future longitudinal studies should evaluate the efficacy and safety of antidepressant use in NHs thus providing evidence for recommendations for clinical practice.
KW - Antidepressants
KW - Nursing homes
KW - Older adults
UR - http://www.scopus.com/inward/record.url?scp=85090003835&partnerID=8YFLogxK
U2 - 10.1186/s12877-020-01730-5
DO - 10.1186/s12877-020-01730-5
M3 - Article
C2 - 32854659
VL - 20
SP - 310
JO - BMC Geriatrics
JF - BMC Geriatrics
SN - 1471-2318
IS - 1
M1 - 310
ER -