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

Published online by Cambridge University Press:  09 October 2017

G. Selbæk ,
S. I.M. Janus ,
S. Bergh ,
K. Engedal ,
S. Ruths ,
A. S. Helvik ,
J. Šaltyte Benth  and
S. U. Zuidema
G. Selbæk
Affiliation:
Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
S. I.M. Janus*
Affiliation:
Department of Health Technology & Services Research, University of Twente, Enschede, the Netherlands Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
S. Bergh
Affiliation:
Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
K. Engedal
Affiliation:
Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
S. Ruths
Affiliation:
Research Unit for General Practice, Uni Health/Uni Research, Bergen, Norway Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
A. S. Helvik
Affiliation:
Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway St. Olav's University Hospital, Trondheim, Norway
J. Šaltyte Benth
Affiliation:
Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway HØKH, Research Centre, Akershus University Hospital, Lørenskog, Norway
S. U. Zuidema
Affiliation:
Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
*
Correspondence should be addressed to: Sarah Janus, University of Twente, Department of Health Technology and Services Research, PO Box 217, 7500 AE Enschede, the Netherlands. Phone +31 53 489 3915. Email: [email protected].
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Abstract

Background:

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 symptomsnursing homepsychotropic drugs
Type
Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 3: Issue Theme: Psychosocial Interventions for Dementia , March 2018 , pp. 385 - 394
Copyright
Copyright © International Psychogeriatric Association 2017 

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