Related Experiment Videos
Does the context matter? Utilization of sedative drugs in nursing homes--a multilevel analysis
A Sonntag1, H Matschinger, M C Angermeyer
1Department of Psychiatry, University of Leipzig, Johannisallee 20, 04317 Leipzig, Germany.
Background:
The aim of this study is to assess the utilization of sedative drugs in nursing homes by means of a multilevel approach taking into account individual as well as institutional characteristics.
Methods:
A retrospective chart review of the drugs consumed in nursing homes in an urban region of Germany was conducted. Individual characteristics were measured by analyzing nursing home files, by staff assessment and by a structured interview conducted by trained psychologists and physicians. Institutional characteristics were assessed by interviewing the management of each facility and ward and by using a staff questionnaire survey. The sample consisted of 1903 residents from 27 nursing homes with a total of 96 wards. Data analysis was carried out by means of a multilevel analysis, a strategy for analyzing hierarchically structured data.
Results:
The utilization of sedative drugs (low potency neuroleptics, anxiolytics, hypnotics) in nursing homes is remarkably high. Thus, 33.3 % of the residents used sedative drugs on a regular basis. PRN prescriptions existed for 13.1 % of the residents, 5.3 % had been using sedative medication prescribed as PRN. Results indicate the influence of individual as well as institutional characteristics on residents' sedative drug utilization. In particular, the use of PRN medicine is determined by characteristics of the ward the individuals are living in.
Conclusion:
Methodological implications: The data analysis concerning the drug utilization of residents of nursing homes requires multilevel models and a distinction between regular and PRN medicine. Further research should focus on explaining institutional variance.
Practical Implications:
Staff training in nonpharmacological strategies to manage disturbing behavior of residents is required.
Related Concept Videos
Sedatives and Hypnotics: Overview
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
Sedatives and Hypnotics Drugs: Miscellaneous Agents
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Sedatives and Hypnotics Drugs: Barbiturates
Sedatives and Hypnotics Drugs: Benzodiazepines
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
CNS Depressants: Barbiturates and Benzodiazepines
Stages of General Anesthesia