Antipsychotic drug use in Canadian long-term care facilities: prevalence, and patterns following resident relocation.
OBJECTIVE
Data on antipsychotic use were collected in two Canadian long-term care (LTC) facilities. During the one-year study, residents in one facility were relocated to a new facility, allowing examination of the changes in antipsychotic use associated with relocation.


METHODS
A comparative descriptive design was used. Pharmacy and chart data on antipsychotic use were gathered for three separate one-month periods during one year. Data were collected both in a facility experiencing relocation of all residents to a new facility, and in a facility not undergoing relocation. The three one-month data collection periods covered a one-month period before the relocation, immediately after the relocation, and six months after the relocation.


RESULTS
In the facility not experiencing relocation, an average of 31.3% of all residents were receiving antipsychotics. Residents in this facility received antipsychotics for an average length of 0.81 years, and 20.8% of all antipsychotic prescriptions reflected dose reductions within six months of the start of the prescription. Only 8.1% of prescriptions had accompanying documentation on the behavioral indication for the use of antipsychotics. A total of 73.4% of all antipsychotics were 'atypical' antipsychotics, and 13.5% of all antipsychotic prescriptions were written as 'p.r.n.' (as needed). While the use of antipsychotics remained relatively constant in the non-relocation facility (between 30.3% and 33.1% of all residents), the percentage of residents receiving antipsychotics in the facility experiencing a relocation climbed significantly; from 21.5% six months before the move, to 32.6% immediately after the move, to 36.9% six months after the move.


CONCLUSIONS
These findings, when compared with the U.S. standards on antipsychotic use (OBRA), suggest the need for additional research on antipsychotic use in Canadian LTC facilities.
Hagen
Brad
B
School of Health Sciences, The University of Lethbridge, 4401 University Drive, Lethbridge, Alberta T1K 3M4, Canada. brad.hagen@uleth.ca
Esther
Chris Armstrong
CA
Ikuta
Roland
R
Williams
Robert J
RJ
Le Navenec
Carole-Lynne
CL
Aho
Morgan
M
D000223:Adaptation, Psychological / Q000187:drug effects; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D002170:Canada / Q000453:epidemiology; D003704:Dementia / Q000188:drug therapy; D006801:Humans; D008016:Life Change Events; D008134:Long-Term Care / Q000523:psychology*; D010300:Parkinson Disease / Q000188:drug therapy / Q000453:epidemiology; D010360:Patient Transfer; D015995:Prevalence; D012112:Residential Facilities; D013315:Stress, Psychological / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology
D014150:Antipsychotic Agents