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Patterns of psychotropic medication use in nursing homes: surveys in Sydney, allowing comparisons over time and between countries

Published online by Cambridge University Press:  24 March 2011

John Snowdon ,
Daniel Galanos  and
Divya Vaswani
John Snowdon*
Affiliation:
Concord Hospital, Sydney, NSW, Australia
Daniel Galanos
Affiliation:
Concord Hospital, Sydney, NSW, Australia
Divya Vaswani
Affiliation:
Concord Hospital, Sydney, NSW, Australia
*
Correspondence should be addressed to: John Snowdon, Clinical Professor, Sydney Medical School, Jara Unit, Concord Hospital, NSW 2139, Australia. Phone: +61-2-97675000; Fax: + 61-2-97678951. Email: [email protected].
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Abstract

Background: This study aimed to explore changes in patterns of use of psychotropic medication in Sydney nursing homes over recent years, and to compare current usage rates with those reported from other countries.

Methods: Data were obtained from 44 of the 48 nursing homes in a central Sydney health area. Researchers noted details from medication cards concerning residents’ age, gender and all currently prescribed drugs, checking whether medication had been given as prescribed. Frequency of administration of “as required” drugs in the previous four weeks was noted.

Results: The pattern of use of psychotropic medication changed considerably between 1993 and 2009. The number of residents taking regularly administered antipsychotics increased by 24% during 1998–2009, though mean dosages decreased. In 2009, fewer residents took hypnotic and/or anxiolytic medications than in the 1990s, and fewer than in countries from which equivalent data have been reported. Antidepressant use increased over the 16 years but only to 25.6%. Only 3% of residents in Sydney nursing homes in 2009 took cognition-enhancing drugs.

Conclusions: Compared to other countries, rates of use of hypnotic, anxiolytic and antidepressant medication in Sydney nursing homes are low. Benefits and disadvantages of these differences merit analysis. Antipsychotic medications were administered to similar percentages of survey residents in 1993 and 2009, but at lower mean dosages in 2009 compared to previous surveys, and with a change to using mainly atypical antipsychotic drugs. Compared to various other countries, cognition-enhancing and antidepressant medications are administered to proportionally fewer residents in Sydney nursing homes. Outcome analysis regarding the use and benefits of such drugs in nursing homes is desirable.

Keywords

antipsychoticantidepressanthypnoticanxiolyticacetylcholinesterase inhibitorsmemantineresidential caredosage
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 9 , November 2011 , pp. 1520 - 1525
Copyright
Copyright © International Psychogeriatric Association 2011

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