Related Experiment Videos
Psychotropic medication use in Swiss nursing homes
I Lustenberger1, B Schüpbach, A von Gunten
1Department of Old Age Psychiatry, University Hospital of Psychiatry, Murtenstrasse, Bern, CH. irene.lustenberger@puk.unibe.ch
Swiss Medical Weekly
|October 6, 2011
Summary
Long-term antipsychotic use is common in nursing home residents with dementia, despite potential risks. Reconsidering this practice is crucial given new guidelines recommending it as a second-line treatment for specific symptoms only.
Area of Science:
- Geriatric Medicine
- Psychopharmacology
- Dementia Care
Background:
- Psychotropic medications, including antipsychotics, are frequently used in nursing homes to manage behavioral and psychological symptoms of dementia (BPSD).
- While antipsychotics can alleviate BPSD in some individuals, they carry significant risks, including increased mortality and accelerated disease progression.
- This study examined psychotropic medication patterns in a representative sample of Swiss nursing home residents.
Purpose of the Study:
- To analyze the prevalence and patterns of psychotropic medication use in nursing home residents.
- To investigate the association between dementia, behavioral symptoms, and psychotropic drug prescription.
- To evaluate the long-term use of antipsychotics and antidepressants in this population.
Main Methods:
- Retrospective analysis of the Resident Assessment Instrument Minimum Data Set (RAI-MDS).
- Inclusion of data from 90 nursing homes, encompassing 18,853 residents at entry and 12,101 at follow-up.
- Statistical analysis to compare medication use between residents with and without dementia and to identify predictors of continued use.
Main Results:
- 40.2% of residents had dementia, with 49.0% experiencing behavioral symptoms.
- Residents with dementia received psychotropic medication more frequently (70.8%) than those without (55.0%).
- Antipsychotics were predominantly prescribed for residents with dementia and behavioral disturbances, with 69.5% using them continuously long-term.
Conclusions:
- Long-term antipsychotic use in nursing home residents with dementia warrants reconsideration.
- Current evidence suggests antipsychotics should be a second-line treatment for dementia, reserved for psychosis or severe aggression, and used for the shortest possible duration.
- Adherence to updated treatment recommendations is essential for optimizing dementia care in long-term facilities.
Related Concept Videos
01:28Drug Therapy
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
01:26Psychosis: Goals of Pharmacotherapy
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation. For...
01:15Drug Dosing: Geriatric Patients
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
01:21Antipsychotic Drugs: Therapeutic Uses and Side Effects
Antipsychotic drugs primarily block dopamine and serotonin receptors and cholinergic, adrenergic, and histaminergic receptors, thereby reducing hallucinations and delusions in conditions like schizophrenia. However, they can trigger unwanted extrapyramidal effects such as dystonias, Parkinson-like symptoms, and tardive dyskinesia.
Despite these side effects, antipsychotics are used therapeutically for various purposes, including managing schizophrenia, preventing nausea and vomiting, curbing...
Despite these side effects, antipsychotics are used therapeutically for various purposes, including managing schizophrenia, preventing nausea and vomiting, curbing...
01:28Psychosis and Antipsychotic Drugs: Overview
The term "psychosis" refers to a spectrum of mental disorders characterized by abnormal thoughts, perceptions, and behaviors. It can manifest as mood disorders, dementia, delirium with psychotic features, substance-induced psychosis with psychotic features, brief psychotic disorder, delusional disorder, schizoaffective disorder, and schizophrenia. Among all these disorders, schizophrenia is the most common psychotic disorder, affecting 1% of the worldwide population. Psychotic symptoms in all...