A retrospective, longitudinal study of factors associated with new antipsychotic medication use among recently admitted long-term care residents

BMC Geriatrics

John P Hirdes⁵  Rosa Liperoti⁴  Koen Milisen¹  Daniela Fialova⁶  Nathalie IH Wellens³  Anna Ballokova²  Andrea Foebel⁵ 

[1] Division of Geriatric Medicine, Leuven University Hospital, Herestraat 49, Leuven 3000, Belgium;Department of Geriatrics and Gerontology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic;Geriatrics Center and Institute of Gerontology, University of Michigan, Ann Arbor, MI, USA;Centro Medicina dell’Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy;School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada;Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Kralove, Charles University, Prague, Czech Republic

关键词: InterRAI assessment instruments;    Risk factors;    Antipsychotic medications;    Mental health;    Long-term care;   

Others  :  1231966
DOI  :  10.1186/s12877-015-0127-8

 received in 2015-03-18, accepted in 2015-10-12,  发布年份 2015

【 摘 要 】

Background

Use of antipsychotic (AP) medications is high and often inappropriate among institutionalized populations. Little is known about the correlates of new AP drug use following admission to long-term care (LTC) settings. This study investigated the frequency and correlates of new AP drug use among newly admitted LTC residents.

Methods

This longitudinal, retrospective study used data from the interRAI - Nursing Home Minimum Data Set version 2.0 (MDS 2.0) instrument. Data about demographic, clinical and social characteristics, and medication use, were collected in Ontario, Canada, from 2003–2011 by trained nurses. Residents with complete admission and 3–6 month follow-up data were included (N = 47,768). Multivariate logistic regression analyses, stratified by gender, explored correlates of new AP drug use upon admission to LTC.

Results

New AP drug users comprised 7 % of the final cohort. Severe cognitive impairment, dementia, and motor agitation were significantly associated with new AP drug use among both sexes. Additionally, behavioural problems, conflicts with staff and reduced social engagement were strong correlates of new AP drug use.

Conclusions

Social factors were as strongly associated with new AP drug use after LTC admission as clinical factors. Strategies to prevent the potential misuse of AP drugs upon LTC admission should consider the social determinants of such prescribing.

【 授权许可】

   
2015 Foebel et al.

【 图 表 】

Fig. 1.

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