Frequency and appropriateness of antipsychotic medication use in older people in long-term care.
BACKGROUND
Many studies have reported excessive use of antipsychotic medications in long stay institutions in Britain and America.


OBJECTIVE
We examined the frequency and appropriateness of antipsychotic prescribing in a variety of extended care settings in the west of Ireland.


METHODS
Clinical details of 345 residents (211 public and 134 private) were obtained from medication sheets and medical notes and by interviewing nursing staff. American prescribing guidelines were applied for those residents taking antipsychotic medications.


RESULTS
Of the 345 residents, 80 (23%) were prescribed regular antipsychotic medications of whom 41 (51%) were deemed to be receiving these agents inappropriately. There was no difference in the use of antipsychotic drugs (21.3% vs. 26.1%, Chi-sq = 1.1, p = 0.3) between residents of public and private units. However, inappropriate antipsychotic use was more common among those in private care (23/35 (66%) vs. 18/45 (40%); Chi-sq = 5.2, p = 0.02). Prominent inappropriate indications for antipsychotic use were: restlessness (26/41 (63%) patients); history of very intermittent aggression (23 (56%) patients); and wandering (19 (46%) patients).


CONCLUSIONS
Inappropriate use of antipsychotic medications, as judged by American legislative guidelines, is common in long-stay units in the west of Ireland.
Murphy
J
J
Western General Practice Training Scheme, Dublin, Ireland.
O'Keeffe
S T
ST
D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000592:standards* / Q000627:therapeutic use*; D004363:Drug Utilization; D005260:Female; D006801:Humans; D007494:Ireland; D008134:Long-Term Care / Q000592:standards* / Q000706:statistics & numerical data; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'
D014150:Antipsychotic Agents