title: Trends in treatment of pneumonia among Dutch nursing home patients with dementia.
abstract: OBJECTIVE
  To test if care to relief suffering in patients with dementia who become ill with pneumonia is improving, we compared treatments in cohorts of patients with dementia and pneumonia a decade apart.
  
  
  METHODS
  We studied 61 nursing homes in The Netherlands between 1996-1998 and 54 nursing homes between 2006-2007, 53 of which had been in the earlier cohort. In 1996-1998, 706 patients with pneumonia and dementia were prospectively enrolled by 201 physicians and in 2006-2007, 72 patients by 69 physicians. Data collected included treatment, physician and patient characteristics, outcome, and additionally, in the 2006-2007 cohort only, physicians' perception of changes in treatment they generally provide.
  
  
  RESULTS
  The frequency of providing antibiotics was similar: 79% in the recent cohort versus 77% ten years earlier (p = 0.63) as was oral antibiotic treatment (91% of those receiving antibiotics versus 88%; p = 0.44). Treatment to relieve symptoms was provided more frequently in the more recent cohort. For example, antipyretics (54% versus 34%; p = 0.001), oxygen (29% versus 13%; p < 0.001), and opiates (22% versus 10%; p = 0.003). Differences were not explained by different case mix. Half of physicians (49%) stated they generally treat to relieve symptoms more frequently than before.
  
  
  CONCLUSIONS
  Symptom relief to Dutch patients with dementia and pneumonia is provided more frequently than a decade ago while the rate of treatment with antibiotics is unchanged. Further studies in The Netherlands and elsewhere are needed to detect if this is a general trend.
authors.affiliation: EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands. j.vandersteen@vumc.nl
authors.forename: Jenny T
authors.initials: JT
authors.lastname: van der Steen
authors.forename: Inga
authors.initials: I
authors.lastname: Meuleman-Peperkamp
authors.forename: Miel W
authors.initials: MW
authors.lastname: Ribbe
mesh_terms: D000369:Aged, 80 and over; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003704:Dementia; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D009426:Netherlands; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010102:Oxygen Inhalation Therapy; D010166:Palliative Care; D011014:Pneumonia / Q000188:drug therapy*; D011594:Psychometrics
chemical_list: D018712:Analgesics, Non-Narcotic; D000900:Anti-Bacterial Agents