Psychotropic and psychoactive drugs and hospitalization rates in nursing facility residents

The purpose of this study was to determine if there were any differences in hospitalization rates due to total psychoactive drug "load" between those using and not or formerly using psychotropic and psychoactive medications in a skilled nursing facility; to determine if the diagnosis of dementia and the change in use and load of psychotropic and psychoactive drugs influenced hospitalization rates.

An observational retrospective cohort study was conducted of patient chart, facility disposition changes and consultant pharmacist reports data from a skilled nursing facility of more than 100 beds. Some177 patients resident for 30 or more days over a 19 month period of 2978 patient- months data were tabulated. A monthly repeated- measures assessment method that incorporated all conditions, diseases and medication changes was done on each resident to determine patient demographics, medication usage, and hospitalizations.

The rates of hospitalization ranged from 0.04 to 0.07 per patient/month for any psychoactive usage in those with and without dementia as a diagnosis. The rate of hospitalization during the study period for those with no current psychotropic nor regular psychoactive usage was 0.02 and 0.03/pt./month for those respectively with and without the diagnosis of dementia, yet 86% of this sample had used psychotropics or other psychoactive drugs before the period of observation.

Preliminary evidence is offered that suggests psychotropics and psychoactive drugs and the total "load" of these drugs may be associated with an increase in the rate and risk of all hospitalizations within a single skilled nursing facility.