PMID- 21971698
OWN - NLM
STAT- MEDLINE
DCOM- 20120221
LR  - 20180802
IS  - 1424-3997 (Electronic)
IS  - 0036-7672 (Linking)
VI  - 141
DP  - 2011
TI  - Psychotropic medication use in Swiss nursing homes.
PG  - w13254
LID - 10.4414/smw.2011.13254 [doi]
AB  - BACKGROUND: Psychotropic medication is commonly used in nursing homes, to treat 
      behavioural and psychological symptoms of dementia (BPSD) for example. Treatment 
      with antipsychotics may improve BPSD in some residents but can be associated with 
      serious side effects, such as higher mortality, faster disease progression and 
      cerebrovascular events. In the current study, psychotropic medication use was 
      analysed in a representative sample of nursing home residents in the 
      German-speaking part of Switzerland, at entry and during follow-up. METHODS: 
      Retrospective analysis of the Resident Assessment Instrument Minimum Data Set 
      (RAI-MDS) of 90 nursing homes at entry (n = 18853) and during follow-up (n = 
      12101). RESULTS: At entry, 7580 residents (40.2%) were diagnosed with dementia 
      and 49.0% of them had behavioural symptoms. Residents with dementia received more 
      psychotropic medication than residents without dementia (70.8% vs. 55.0%; 
      p<0.001). The most commonly prescribed medications were antipsychotics (demented 
      44.8% vs. non-demented 17.4%; p<0.001) and antidepressants (demented 29.6% vs. 
      non-demented 26.7%; p<0.001). Antipsychotics were mainly prescribed for residents 
      with dementia and behavioural disturbances. The longitudinal analysis revealed 
      that most residents with dementia (69.5%) took antipsychotics continuously from 
      entry to the final assessment and the same was true for antidepressants (66.1%). 
      The use of antipsychotics at baseline in residents with dementia predicted 
      (p<0.001) the use of antipsychotics during follow-up. CONCLUSIONS: The long term 
      use of antipsychotics in nursing homes may need to be reconsidered in view of 
      novel treatment recommendations, suggesting that the prescription of 
      antipsychotics for patients with dementia should be a second line treatment, 
      restricted to symptoms of psychosis or severe aggression, and prescribed for the 
      shortest duration possible.
FAU - Lustenberger, I
AU  - Lustenberger I
AD  - Department of Old Age Psychiatry, University Hospital of Psychiatry, 
      Murtenstrasse, Bern, CH. irene.lustenberger@puk.unibe.ch
FAU - Schupbach, B
AU  - Schupbach B
FAU - von Gunten, A
AU  - von Gunten A
FAU - Mosimann, U
AU  - Mosimann U
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20111004
PL  - Switzerland
TA  - Swiss Med Wkly
JT  - Swiss medical weekly
JID - 100970884
RN  - 0 (Psychotropic Drugs)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Dementia/drug therapy/physiopathology
MH  - Europe
MH  - Female
MH  - Humans
MH  - Male
MH  - *Nursing Homes
MH  - Practice Patterns, Physicians'/statistics & numerical data
MH  - Psychotropic Drugs/*therapeutic use
MH  - Retrospective Studies
MH  - Switzerland
EDAT- 2011/10/06 06:00
MHDA- 2012/02/22 06:00
CRDT- 2011/10/06 06:00
PHST- 2011/10/06 06:00 [entrez]
PHST- 2011/10/06 06:00 [pubmed]
PHST- 2012/02/22 06:00 [medline]
AID - smw-13254 [pii]
AID - 10.4414/smw.2011.13254 [doi]
PST - epublish
SO  - Swiss Med Wkly. 2011 Oct 4;141:w13254. doi: 10.4414/smw.2011.13254. eCollection 
      2011.