Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-23T15:59:43.911Z Has data issue: false hasContentIssue false
  • English
  • Français

A survey of psychotropic drug use in elderly psychiatric inpatients

Published online by Cambridge University Press:  13 June 2014

Ruth Loane ,
Sheila McGauran ,
Con Buckley ,
Fenton Howell ,
Zachary Johnson  and
Angela Mohan
Ruth Loane
Affiliation:
Joint Homelessness Team, 8 King Street, Covent Garden, London WC2 E 8HN, England
Sheila McGauran
Affiliation:
Kildare Mental Health, Service, Naas, Co. Kildare, Ireland
Con Buckley
Affiliation:
Resettlement Team, St Brendan's Hospital, Dublin 7, Ireland
Fenton Howell
Affiliation:
Specialist in Public Health Medicine, North Eastern Health Board, Dundalk, Ireland
Zachary Johnson
Affiliation:
Health Information Unit, Eastern Health Board, Dublin, Ireland
Angela Mohan
Affiliation:
St Brendan's Hospital, Dublin 7, Ireland
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: The objective of the present study was to examine the use of medication in an elderly psychiatric inpatient population.

Method: This was a retrospective survey of medication prescribed to the total elderly inpatient population of a single psychiatric hospital. Data collected included basic sociodemographic information, length of stay, number of admissions, frequency of psychiatric disturbance, diagnosis and medication prescribed.

Results: A total of 340 cases were studied, 229 (67%) were female, 324 (95%) had been inpatients for more than one year, 111 (33%) suffered from dementia, while the remainder were in the functional category. In 57% more than one psychotropic drug was used. Over half (56%) of those with dementia were on neuroleptic medication.

Conclusion: Psychotropic polypharmacy was found in this population of elderly patients. Management issues emphasised include the risk of polypharmacy in this age group, the need for staff education, an active pharmacy committee and alternative methods of managing behavioural disturbance in elderly patients in particular those with dementia.

Keywords

PolypharmacyPsychotropicElderlyPsychiatricInpatientsPrescribing
Type
Audits
Information
Irish Journal of Psychological Medicine , Volume 14 , Issue 3 , September 1997 , pp. 108 - 111
Copyright
Copyright © Cambridge University Press 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.The Years Ahead - A Policy for the Elderly. Dublin: Dublin Stationary Office, 1988.Google Scholar
2.Christopher, LJ, Ballinger, BR, Shepherd, AMM, Ramsay, A, Crooks, G. Drug prescribing patterns in the elderly: a cross-sectional study of inpatients. Age Ageing 1978; 7: 74–82.CrossRefGoogle ScholarPubMed
3.Kalchthaler, T, Coccaro, E, Lichtiger, S. Incidence of polypharmacy in a longterm care facility. J Am Geriatr Soc 1977; 25: 308–13.CrossRefGoogle Scholar
4.Task force on late neurological effects of antipsychotic drugs. Summary of a task force report of the American Psychiatric Association. Am J Psychiatry 1980; 137(10); 1163–70.CrossRefGoogle Scholar
5.Ray, WA, Griffin, MR, Schaffher, W. Psychotropic drug use and the risk of hip fracture. N Engl J Med 1987; 316–69.Google ScholarPubMed
6.Granek, E, Baker, SP, Abbey, H. Medications and diagnosis in relation to falls in a longterm care facility. J Am Geriatr Soc 1987; 35: 503–11.CrossRefGoogle Scholar
7.Ray, WA, Federspiel, CF, Schafflner, W. A study of antipsychotic drug use in nursing homes: epidemiologic evidence suggesting misuse. Am J Public Health 1980; 70(5); 485–91.CrossRefGoogle ScholarPubMed
8.Reynolds, MD. Institutional prescribing for the elderly: patterns of prescribing in a municipal hospital and a municipal nursing home. J Am Geriatr Soc 1984; 32(4); 640–5.CrossRefGoogle Scholar
9.Connelly, J. An audit of the use of antipsychotics in a geriatric psychiatry continuing care unit in Scotland. Int J Geriatr Psychiat 1992; 7: 447–53.CrossRefGoogle Scholar
10.McGrath, AM, Jackson, GA. Survey of neuroleptic prescribing in residents of nursing homes in Glasgow. BMJ 1996; 312: 611–2.CrossRefGoogle ScholarPubMed
11.Rovner, BW, Edelman, BA, Cox, MP, Schmuely, Y. The impact of antipsychotic drug regulations on psychotropic prescribing practices in nursing homes. Am J Psychiat 1992; 149(10): 1390–2.Google ScholarPubMed
12.Slater, EJ, Glazer, W. Use of OBRA-87 guidelines for prescribing neuroleptics in a VA Nursing Home. Psychiatric Services 1995; 46(2): 119–21.Google Scholar
13.Avorn, J, Gurwitz, JH. Drug use in the nursing home. Ann Intern Med 1995; 123: 195–204.CrossRefGoogle ScholarPubMed
14.British National Formulary, Number 21. London: British Medical Association and Pharmaceutical Society of Great Britain, 1991.Google Scholar
15.World Health Organisation. Mental disorders, glossary and guide to their classification in accordance with the ninth revision of the International Classification of Diseases (ICD-9). Geneva: WHO, 1978.Google Scholar
16.Michel, K, Kolakowska, T. A survey of psychotropic drug prescribing in two psychiatric hospitals. Br J Psychiatry 1981; 138: 217–21.CrossRefGoogle ScholarPubMed
17.Edwards, S, Kumar, V. A survey of prescribing of psychotropic drugs in a Birmingham hospital. Br J Psychiatry 1984; 145: 502–7.CrossRefGoogle Scholar
18.Clark, F, Holden, NL. The persistence of prescribing habits: a survey and follow-up of prescribing to chronic hospital inpatients. Br J Psychiatry 1987; 150: 88–91.CrossRefGoogle Scholar
19.Semla, TP, Palla, K, Poddig, B, Brauner, DJ. Effect of Omnibus Reconciliation Act 1987 on antipsychotic prescribing in nursing home residents. J Am Geriatr Soc 1994; 42: 648–52.CrossRefGoogle ScholarPubMed
20.Schneider, LS, Pollock, VE, Lyness, SA. A meta-analysis of controlled trials of neuroleptic treatment in dementia. J Am Geriatr Soc 1990; 38: 553–63.CrossRefGoogle ScholarPubMed
21.Murphy, D, Gannon, MA, Fitzpatrick, Det al.A study of the prescribing of psychotropic drugs in a Dublin psychiatric hospital. Ir J Psych Med 1990; 7: 26–30.CrossRefGoogle Scholar
22.McClelland, HA, Blessed, G, Bhate, S, Ali, N, Clarke, PA. The abrupt withdrawal of antiparkinsonian drugs in schizophrenic patients. Br J Psychiatry 1974; 124: 151–9.CrossRefGoogle ScholarPubMed
23.Klett, CJ, Caffey, E. Evaluating the longterm need for antiparkinsonian drugs by chronic schizophrenics. Arch Gen Psychiatry 1972; 26: 374–9.CrossRefGoogle ScholarPubMed
24.Orlov, P, Kasparian, G, Dimascio, A, Cole, JO. Withdrawal of antiparkinsonian drugs. Arch Gen Psychiatry 1971; 25: 410–2.CrossRefGoogle Scholar
25.Perris, C, Dimitrijev, P, Jacobsson, L, Paulson, P, Rapp, W, Froberg, H. Tardive dyskinesia in psychiatric patients treated with neuroleptics. Br J Psychiatry 1979; 135: 509–14.CrossRefGoogle ScholarPubMed
26.Rifkin, A, Quitken, F, Kane, J, Struve, F, Klein, DF. Are prophylactic antiparkinsonian drugs necessary? Arch Gen Psychiatry 1978; 35: 483–9.CrossRefGoogle ScholarPubMed
27.Potamianos, G, Kellet, JM. Anticholinergic drugs and memory: the effects of benzhexol on memory in a group of geriatric patients. Br J Psychiatry 1982; 140: 470–2.CrossRefGoogle Scholar
28.Kalish, SC, Bohn, RL, Mogun, H, Glynn, RJ, Gurwitz, JH, Avorn, J. Antipsychotic prescribing patterns and trie treatment of extrapyramidal symptoms in older people. J Am Geriatr Soc 1995; 43: 967–73.CrossRefGoogle Scholar
29.Morgan, R, Gopalaswamy, AK. Psychotropic drugs: another survey of prescribing habits. Br J Psychiatry 1984; 144: 298–302.CrossRefGoogle Scholar