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Psychotropic drugs in nursing- and old-age homes: relationships between needs of care and mental health status

  • Pharmacoepidemiology and Prescription
  • Published:
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Abstract

Objective

The aim of the present study was to map out what kind of psychotropic drugs are prescribed for elderly residents in assisted-living homes and how they relate to age, sex, form of living, psychiatric diagnosis, care needs and mental health status, and to identify factors of importance for their use; and to study the indication for treatment and the evaluation of the effects of treatment.

Method

The study had a cross-sectional design and included one-third of all patients (n=175) living in old-age homes or in nursing homes in a municipality in southern Sweden. Data concerning medication was obtained from medical records and included all psychotropic drugs prescribed the day the study started and the previous month. Need of care was assessed using Katz index, and mental health status was assessed using the Organic Brain Syndrome scale.

Results

Of the study population, 128 (73%) used one or more psychoactive drug. Prescribed drugs were neuroleptics (16%), anxiolytics (32%), hypnotics, (45%), and anti-depressants (33%). A greater prescription of neuroleptics than anti-depressants was seen for those showing signs of depression, and caution with prescription of benzodiazepines was seen for those showing signs of dementia. An indication and evaluation of treatment was lacking in half of the cases. Treatment with psychiatric drugs existed for approximately 50% of those without a determined psychiatric diagnosis.

Conclusion

We have found a frequent use of neuroleptics, anxiolytics and hypnotics in the elderly, but an underprescription of anti-depressants appears to exist. There is a lack of documentation of indications and evaluations of psychotropic medication.

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Acknowledgements

The authors wish to thank all staff members and residents at the nursing homes and old-age homes for their collaboration. We are most grateful to Christin Tornvall for help with interviews and to Anders Håkansson, Ph.D., for revising the language. The study was supported by Capio Research Foundation.

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Authors and Affiliations

  1. Department of Nursing, Lund University, Sweden

    Ing-Britt Holmquist & Bengt Svensson

  2. Department of Clinical Pharmacology, Lund University Hospital, 221 85 , Lund, Sweden

    Peter Höglund

Authors
  1. Ing-Britt Holmquist
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  2. Bengt Svensson
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  3. Peter Höglund
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Correspondence to Peter Höglund.

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Holmquist, IB., Svensson, B. & Höglund, P. Psychotropic drugs in nursing- and old-age homes: relationships between needs of care and mental health status. Eur J Clin Pharmacol 59, 669–676 (2003). https://doi.org/10.1007/s00228-003-0679-y

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  • DOI: https://doi.org/10.1007/s00228-003-0679-y

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