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

Colin McCowan, Parker Magin, Stella Clark, Bruce Guthrie

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    Abstract

    Objective: to compare the prescription of psychotropic medications for patients living in care homes with that for patients living at home.

    Design and setting: retrospective population database study in the Tayside region of Scotland.

    Subjects: 70,297 patients aged =65 and followed until death or the end of the study.

    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.

    Results: people living in care (4.1%) received 9.80 more prescribed items (P < 0.001) from 1.63 more British National Formulary (BNF) categories (P < 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).

    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).

    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.
    Original languageEnglish
    Pages (from-to)51-56
    Number of pages6
    JournalAge and Ageing
    Volume42
    Issue number1
    DOIs
    Publication statusPublished - 1 Jan 2013

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