title: Antiepileptic drug use in nursing home admissions.
abstract: Although 1 of 10 nursing home residents is taking an antiepileptic drug (AED), no study to our knowledge has determined whether most residents are already receiving AED treatment when they are admitted or are given these drugs afterward. That differentiation was the focus of this study. The study group consisted of 10,318 residents, 65 years and older, admitted to 510 nursing homes located throughout the United States during the first quarter of 1999. AED prevalence at admission was 7.7%; three fifths had an epilepsy/seizure indication. In a multivariate analysis, factors associated with AED use at admission included epilepsy/seizure, bipolar depression, age group, and cognitive performance. In the follow-up cohort (N = 9,516), postadmission initiation of AEDs was 2.7%; one fifth had an epilepsy/seizure indication. In the multivariate analysis, factors associated with postadmission AED initiation included epilepsy/seizure indication, bipolar depression, age group, peripheral vascular disease, and cognitive performance. This rate of AED postadmission initiation within the first 3 months of admission was much higher than expected, suggesting that new symptoms may develop after admission. Results also show that the rate of AED use in nursing homes is not static.
authors.affiliation: Division of Health Services Research and Policy, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA. jgarrard@umn.edu
authors.forename: Judith
authors.initials: J
authors.lastname: Garrard
authors.forename: Susan
authors.initials: S
authors.lastname: Harms
authors.forename: Nancy
authors.initials: N
authors.lastname: Hardie
authors.forename: Lynn E
authors.initials: LE
authors.lastname: Eberly
authors.forename: Nicole
authors.initials: N
authors.lastname: Nitz
authors.forename: Patricia
authors.initials: P
authors.lastname: Bland
authors.forename: Cynthia R
authors.initials: CR
authors.lastname: Gross
authors.forename: Ilo E
authors.initials: IE
authors.lastname: Leppik
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D015331:Cohort Studies; D004363:Drug Utilization / Q000706:statistics & numerical data; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009735:Nursing Homes; D010343:Patient Admission / Q000706:statistics & numerical data*; D015995:Prevalence; D012720:Severity of Illness Index; D013997:Time Factors; D014481:United States / Q000453:epidemiology
chemical_list: D000927:Anticonvulsants