Changes to psychotropic medications in the six months after admission to nursing homes in Melbourne, Australia.
BACKGROUND
Nursing home residents are often prescribed large numbers of psychotropic medications. Previous studies suggest that antipsychotic medications are often unnecessary and can be withdrawn without ill effects. Depression, in contrast, is believed to be under-recognized and under-treated.


METHODS
A six-month audit was carried out of the antipsychotic, antidepressant, anxiolytic and hypnotic medications prescribed to 166 newly admitted residents of a convenience sample of seven nursing homes in Melbourne, Australia.


RESULTS
Over the six-month period, antidepressants were started in 6% of all cases and stopped in 2% of treated cases. Antipsychotics were added in 5% of all cases and stopped in 15% of treated cases. Residents were switched from one antidepressant to another in 5% of treated cases and from one antipsychotic to another in 4%. Benzodiazepine use was relatively modest.


CONCLUSIONS
Judging from epidemiological data, treatment revisions were almost certainly insufficient to address residents' mental health needs. We discuss ways of harnessing existing nursing and pharmacy resources to ensure better care for aged residents.
O'Connor
Daniel W
DW
Aged Mental Health Research Unit, School of Psychology and Psychiatry, Monash University, Melbourne, Australia. daniel.oconnor@med.monash.edu.au
Griffith
Joanne
J
McSweeney
Kate
K
D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D001569:Benzodiazepines / Q000627:therapeutic use; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D017723:Drug Utilization Review / Q000706:statistics & numerical data; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008499:Medical Records; D001523:Mental Disorders / Q000188:drug therapy* / Q000523:psychology; D008875:Middle Aged; D009735:Nursing Homes; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012737:Sex Factors; D013997:Time Factors
D011619:Psychotropic Drugs; D001569:Benzodiazepines