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Antipsychotic drug use in Canadian long-term care facilities: prevalence, and patterns following resident relocation

Published online by Cambridge University Press:  07 June 2005

Brad Hagen
Affiliation:
School of Health Sciences, The University of Lethbridge, Alberta, Canada
Chris Armstrong Esther
Affiliation:
School of Health Sciences, The University of Lethbridge, Alberta, Canada
Roland Ikuta
Affiliation:
Senior's Health, The Chinook Health Region, Lethbridge, Alberta
Robert J. Williams
Affiliation:
School of Health Sciences, The University of Lethbridge, Alberta, Canada
Carole-Lynne Le Navenec
Affiliation:
School of Nursing, The University of Calgary, Alberta, Canada
Morgan Aho
Affiliation:
School of Health Sciences, The University of Lethbridge, Alberta, Canada

Abstract

Background and aims: Data on antipsychotic use were collected in two Canadian long-term care (LTC) facilities. During the one-year study, residents in one facility were relocated to a new facility, allowing examination of the changes in antipsychotic use associated with relocation.

Method: A comparative descriptive design was used. Pharmacy and chart data on antipsychotic use were gathered for three separate one-month periods during one year. Data were collected both in a facility experiencing relocation of all residents to a new facility, and in a facility not undergoing relocation. The three one-month data collection periods covered a one-month period before the relocation, immediately after the relocation, and six months after the relocation.

Results: In the facility not experiencing relocation, an average of 31.3% of all residents were receiving antipsychotics. Residents in this facility received antipsychotics for an average length of 0.81 years, and 20.8% of all antipsychotic prescriptions reflected dose reductions within six months of the start of the prescription. Only 8.1% of prescriptions had accompanying documentation on the behavioral indication for the use of antipsychotics. A total of 73.4% of all antipsychotics were ‘atypical’ antipsychotics, and 13.5% of all antipsychotic prescriptions were written as ‘p.r.n.’ (as needed). While the use of antipsychotics remained relatively constant in the non-relocation facility (between 30.3% and 33.1% of all residents), the percentage of residents receiving antipsychotics in the facility experiencing a relocation climbed significantly; from 21.5% six months before the move, to 32.6% immediately after the move, to 36.9% six months after the move.

Conclusion: These findings, when compared with the U.S. standards on antipsychotic use (OBRA), suggest the need for additional research on antipsychotic use in Canadian LTC facilities.

Type
Research Article
Copyright
© International Psychogeriatric Association 2005

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