Psychotropic drug prescription for nursing home residents with dementia: prevalence and associations with non-resident-related factors.
Claudia H. W. Smeets,Debby L. Gerritsen,Sytse U Zuidema,Steven Teerenstra,Klaas van der Spek,Martin Smalbrugge,Raymond T.C.M. Koopmans +6 more
TLDR
Prescription rates for antipsychotics are similar compared to other countries, and relatively low for antidepressants, anxiolytics, and hypnotics, which indicates that improvement of prescribing could provisionally best be targeted at resident-related factors.Abstract:
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 0.9...read more
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Does Organisational Culture Influence Prescribing in Care Homes for Older People?: A New Direction for Research.
TL;DR: Consideration of organisational culture within care-home settings may help to understand what drives prescribing decisions in this particularly vulnerable patient group and thus provide new directions for future strategies to promote quality care.
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Trends in Antipsychotic and Mood Stabilizer Prescribing in Long-Term Care in the U.S.: 2011-2014.
Lauren B. Gerlach,Helen C. Kales,Hyungjin Myra Kim,Julie P.W. Bynum,Claire Chiang,Julie Strominger,Donovan T. Maust,Donovan T. Maust +7 more
TL;DR: The likelihood of antipsychotic and mood stabilizer treatment did not decline for residents with depression or bipolar disorder, for whom such prescribing may be appropriate but who were not excluded from the Partnership's antipsychotics quality measure.
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The health professional experience of using antipsychotic medication for dementia in care homes: A study using grounded theory and focussing on inappropriate prescribing
TL;DR: Positive perceptions based on past experiences with antipsychotics should be challenged through future interventions that tackle inappropriate prescribing, for example using behaviour change techniques to better highlight adverse consequences of prescribing.
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Polypharmacy in Assisted Living and Impact on Clinical Outcomes.
Barbara Resnick,Elizabeth Galik,Marie Boltz,Sarah Holmes,Steven Fix,Erin Vigne,Shijun Zhu,Regina Lewis +7 more
TL;DR: Investigation of age, gender, race, setting, multi-morbidity, and cognitive status will help guide deprescribing so that medication management does not harm older adults physically or cause unnecessary financial burden.
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