Psychotropic Drug Use Among Danish Care Home Residents During and After the COVID-19 Pandemic

The COVID-19 pandemic and related measures led to social isolation and disrupted daily routines for care home residents, potentially harming their mental health. This study explored changes in incident psychotropic drug use among Danish care home residents during and after the pandemic.

We conducted an interrupted time series analysis on all individuals admitted to Danish care homes between 2015 and 2023 (n = 128,915). We compared monthly rates of incident psychotropic drug use during and after the COVID-19 pandemic with predictions from the pre-pandemic trends, estimating the excess number of cases for each period.

At care home admission, residents had a median age of 85 years (interquartile range: 78-90), and 51% used psychotropic drugs. During the pandemic, incident psychotropic drug use exceeded levels expected from the pre-pandemic trend (179 excess users/10,000 residents; 95% confidence interval (CI): 72-286), with small increases for antidepressants (68/10,000; 95% CI: 7.9-128) and antipsychotics (81/10,000; 95% CI: 36-126). In the post-pandemic period, overall incident psychotropic use remained higher than expected from the pre-pandemic trend (343/10,000; 95% CI: 29-656). Although on a declining trend, incidence rates for antidepressants and Z-drugs were slightly elevated in the post-pandemic period (antidepressants: 237/10,000; 95% CI: 83-390; Z-drugs: 60/10,000; 95% CI: 23-98), while incident antipsychotic use returned to the pre-pandemic trend. Benzodiazepines and melatonin showed no substantial changes. Among incident psychotropic drug users during and after the pandemic, 58% had recent exposure to another psychotropic drug class, and 71% continued treatment beyond 6 months.

Incident psychotropic drug use among Danish care home residents increased during the COVID-19 pandemic and remained slightly elevated afterward. This warrants closer scrutiny of prescribing practices and highlights the need for targeted interventions to optimize psychotropic drug use in the post-pandemic era.