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Int Psychogeriatr. 2018 Mar;30(3):385-394. doi: 10.1017/S1041610217001788. Epub 2017 Oct 9.

Change in psychotropic drug use in Norwegian nursing homes between 2004 and 2011.

Author information

1
Norwegian National Advisory Unit on Ageing and Health,Vestfold Hospital Trust,Tønsberg,Norway.
2
Department of Health Technology & Services Research,University of Twente,Enschede,the Netherlands.
3
Research Unit for General Practice,Uni Health/Uni Research,Bergen,Norway.
4
Centre for Old Age Psychiatric Research,Innlandet Hospital Trust,Ottestad,Norway.
5
Department of General Practice and Elderly Care Medicine,University of Groningen,University Medical Centre Groningen,Groningen,the Netherlands.

Abstract

ABSTRACTBackground:We aimed to assess whether there were any changes in the use of psychotropic drugs in Norwegian nursing homes between 2004 and 2011. Also, we investigated whether the predictors of use of specific psychotropic drug groups have changed.

METHODS:

We conducted a secondary analysis of two cohort studies of two Norwegian nursing home samples (2004/05 and 2010/11). Multivariate models were applied.

RESULTS:

We found a significant decrease in the prescription of antipsychotic drugs between 2004 and 2011 (0.63 OR, 95%CI = 0.49-0.82, p < 0.001) even after adjusting for relevant demographic and clinical variables. There are only minor changes for the other psychotropic drugs. We found that (1) the use of specific psychotropic drug groups as well as the number of psychotropic drugs used was associated with more affective symptoms and (2) the use of specific psychotropic drug groups as well as the number of psychotropic drugs used was associated with lower scores on the Physical Self-Maintenance scale.

CONCLUSION:

This is the first study to show a robust decrease in antipsychotic drug use in nursing home patients with dementia unrelated to possible changes in case mix. The change might be explained by treatment recommendations against its use except in the most severe conditions of aggression or psychosis. Our findings indicate that it takes several years to implement scientific knowledge in clinical practice in nursing homes.

KEYWORDS:

Neuropsychiatric symptoms; nursing home; psychotropic drugs

PMID:
28988552
DOI:
10.1017/S1041610217001788
[Indexed for MEDLINE]

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