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Prevalence and correlates of psychotropic drug use in Dutch nursing-home patients with dementia

Published online by Cambridge University Press:  16 April 2009

Renate M. Nijk ,
Sytse U. Zuidema  and
Raymond T. C. M. Koopmans
Renate M. Nijk*
Affiliation:
Center for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen, Medical Centre, Nijmegen, The Netherlands van Neynselgroep, 's Hertogenbosch, The Netherlands
Sytse U. Zuidema
Affiliation:
Center for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen, Medical Centre, Nijmegen, The Netherlands
Raymond T. C. M. Koopmans
Affiliation:
Center for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen, Medical Centre, Nijmegen, The Netherlands
*
Correspondence should be addressed to: R. M. Nijk, van Neynselgroep, P.O Box 90112, 5200 MA, 's Hertogenbosch, The Netherlands. Phone: +31 (0)73 658 3000, Fax: +31 (0)73 680 3060. Email: [email protected].
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Abstract

Background: Neuropsychiatric symptoms in dementia patients are common and are often treated with psychotropic drugs. The aim of this study was to determine the prevalence and correlates of psychotropic drug use in Dutch nursing home patients with dementia.

Methods: Psychotropic drug use of 1322 patients on 59 dementia special care units (SCUs) in 25 nursing homes was registered. Drugs were categorized according to the Anatomical Therapeutical Chemical classification (ATC). The influence of age, gender, dementia stage measured by the Global Deterioration Scale (GDS), and type of neuropsychiatric symptoms on psychotropic drug use was analyzed using binomial logistic regression analysis.

Results: 63% of the patients used at least one psychotropic drug. Psychotropics in general and antipsychotics in particular were most frequently prescribed in GDS stage 6, and in patients aged between 65 and 75 years. Psychotropics in general were positively associated with depression, night-time behavior and agitation. Antipsychotic drug use was positively associated with psychosis, agitation and night-time behavior and was negatively associated with apathy. Anxiolytics were associated with age, psychosis, agitation and night-time behavior. Antidepressants were most frequently prescribed in GDS stage 6 and associated with female gender, agitation and depression. Sedatives were only associated with night-time behavior.

Conclusion: Nursing home patients with dementia have a high prevalence of psychotropic drug use. In particular, the association with neuropsychiatric symptoms raises questions of efficacy of these drugs and the risk of chronic use.

Keywords

dementianeuropsychiatric symptomsnursing homepsychotropic drug useantipsychoticsantidepressantsbehavioral and psychological symptoms of dementia
Type
Research Article
Information
International Psychogeriatrics , Volume 21 , Issue 3 , June 2009 , pp. 485 - 493
Copyright
Copyright © International Psychogeriatric Association 2009

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