An observational study of psychotropic drug use and initiation in older patients resident in their own home or in care

TY - JOUR

T1 - An observational study of psychotropic drug use and initiation in older patients resident in their own home or in care

A1 - McCowan,Colin

A1 - Magin,Parker

A1 - Clark,Stella

A1 - Guthrie,Bruce

AU - McCowan,Colin

AU - Magin,Parker

AU - Clark,Stella

AU - Guthrie,Bruce

PY - 2013/1/1

Y1 - 2013/1/1

N2 - Objective: to compare the prescription of psychotropic medications for patients living in care homes with that for patients living at home.<br/><br/>Design and setting: retrospective population database study in the Tayside region of Scotland.<br/><br/>Subjects: 70,297 patients aged =65 and followed until death or the end of the study.<br/><br/>Methods: examining registered addresses for all people aged 65–99 identified those in care. The prescriptions for a 12-week period was examined and psychotropic drug use compared by their place of residence. Comparisons of prescriptions pre- and post-admission were performed for people admitted to a care home from Jan 2005 to Dec 2006.<br/><br/>Results: people living in care (4.1%) received 9.80 more prescribed items (P &lt; 0.001) from 1.63 more British National Formulary (BNF) categories (P &lt; 0.001) than people living at home over a 12-week period. They were more likely to receive any psychotropic medication (42 versus 16%, odds ratio (OR) 3.09, 95% CI: 2.79–3.41).<br/><br/>Over 70% of 1,715 people admitted to care homes during the study who received psychotropic medication commenced the medication prior to admission. Patients who started anti-psychotics in the 30 days prior to admission were less likely to have stopped them (OR: 0.53, 95% CI: 0.30–0.94).<br/><br/>Conclusion: prolonged prescription of psychotropic medications is commonplace in care home residents. Almost half of the people prescribed antipsychotic drugs received them for a minimum of 6 months. Systematic medication reviews must be established in all care homes to promote safe and effective prescription to this at-risk population.

AB - Objective: to compare the prescription of psychotropic medications for patients living in care homes with that for patients living at home.<br/><br/>Design and setting: retrospective population database study in the Tayside region of Scotland.<br/><br/>Subjects: 70,297 patients aged =65 and followed until death or the end of the study.<br/><br/>Methods: examining registered addresses for all people aged 65–99 identified those in care. The prescriptions for a 12-week period was examined and psychotropic drug use compared by their place of residence. Comparisons of prescriptions pre- and post-admission were performed for people admitted to a care home from Jan 2005 to Dec 2006.<br/><br/>Results: people living in care (4.1%) received 9.80 more prescribed items (P &lt; 0.001) from 1.63 more British National Formulary (BNF) categories (P &lt; 0.001) than people living at home over a 12-week period. They were more likely to receive any psychotropic medication (42 versus 16%, odds ratio (OR) 3.09, 95% CI: 2.79–3.41).<br/><br/>Over 70% of 1,715 people admitted to care homes during the study who received psychotropic medication commenced the medication prior to admission. Patients who started anti-psychotics in the 30 days prior to admission were less likely to have stopped them (OR: 0.53, 95% CI: 0.30–0.94).<br/><br/>Conclusion: prolonged prescription of psychotropic medications is commonplace in care home residents. Almost half of the people prescribed antipsychotic drugs received them for a minimum of 6 months. Systematic medication reviews must be established in all care homes to promote safe and effective prescription to this at-risk population.

UR - http://www.scopus.com/inward/record.url?partnerID=yv4JPVwI&eid=2-s2.0-84871348849&md5=bae69f9d24ce277bade7316780c90dec

U2 - 10.1093/ageing/afs117

DO - 10.1093/ageing/afs117

M1 - Article

JO - Age and Ageing

JF - Age and Ageing

SN - 0002-0729

IS - 1

VL - 42

SP - 51

EP - 56

ER -