Psychotropic drug use in nursing homes--diagnostic indications and variations between institutions.
OBJECTIVE
Psychotropic drug use among nursing home residents with regard to diagnostic indications and patient- and institution characteristics was analysed.


METHODS
A cross-sectional study of medication data from 1552 residents at 23 nursing homes in Bergen, Norway, was performed. Psychotropic drug use (neuroleptics, anxiolytics, hypnotics, antidepressants, and two sedative antihistamines) was analysed with regard to prevalence, diagnostic indications, duration of use, and general patient- and institution characteristics.


RESULTS
Psychotropic drugs were taken on a daily schedule by 59% of all residents, most commonly as long-term treatment. Antidepressants (in 70% selective serotonin re-uptake inhibitors) were used by 31%, neuroleptics by 23%, and benzodiazepines by 22% of all the residents. Neuroleptics were given for non-psychotic behavioural and psychological symptoms in 66% of the cases. Sleeping disorders were most commonly treated with long-acting benzodiazepine hypnotics. Psychotropic drug use decreased with increasing patient age. Drug use patterns varied greatly between the different nursing homes: the prevalence of neuroleptic use varied from 0 to 61% of the residents, and antidepressant use varied from 10 to 63%. In nursing homes providing relatively more physician staff time, the residents were more likely to use antidepressants.


CONCLUSIONS
Psychotropic drugs are used by a majority of nursing home residents as long-term symptomatic treatment. The great variations between the institutions can only to a small extent be explained by quantitative differences between the institutions.
Ruths
S
S
Department of Public Health and Primary Health Care, University of Bergen, Norway. sabine.ruths@isf.uib.no
Straand
J
J
Nygaard
H A
HA
D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis / Q000188:drug therapy; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000706:statistics & numerical data; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy; D009664:Norway; D009735:Nursing Homes / Q000706:statistics & numerical data*; D011595:Psychomotor Agitation / Q000175:diagnosis / Q000188:drug therapy; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000188:drug therapy
D011619:Psychotropic Drugs