[Pharmacotherapy of neuropsychiatric symptoms in dementia in nursing homes: a comparison of service provision by psychiatric outpatient clinics and primary care psychiatrists].
BACKGROUND
Neuropsychiatric symptoms of dementia like agitation, depression and apathy often result in increased prescriptions of psychotropics. In Germany, outpatient clinics at psychiatric hospitals play an important role in the treatment of neuropsychiatric symptoms in nursing homes. The aim of this study was to test whether the severity and pharmacotherapy differed in patients treated by outpatient clinics at psychiatric hospitals, as compared to primary care specialists.


METHODS
A cross-sectional study of the prevalence of agitation, apathy, and depression, and the amount of psychotropics prescribed in defined daily dosages (DDD) in 304 residents with dementia in 18 Berlin nursing homes.


RESULTS
Patients treated by outpatient clinics at psychiatric hospitals suffered from more severe neuropsychiatric symptoms (p < 0.05), were prescribed more antidepressants and antidementia agents (p < 0.05) and, when adjusting for the severity of agitation, less neuroleptics (p < 0.05) as compared to primary care specialists.


CONCLUSIONS
Psychiatric outpatient clinics at hospitals treat more severely demented patients who suffer from severe neuropsychiatric symptoms. The pharmacotherapy provided by these clinics displays a favourable profile according to established treatment guidelines.
Klinik für Psychiatrie und Psychotherapie, Charité Campus Mitte, Berlin. michael.rapp@charite.de
Michael A
MA
Rapp
Tomislav
T
Majic
Jan-Paul
JP
Pluta
Thomas
T
Mell
Jan
J
Kalbitzer
Yvonne
Y
Treusch
Andreas
A
Heinz
Hans
H
Gutzmann
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003704:Dementia / Q000188:drug therapy* / Q000523:psychology; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D006707:Homes for the Aged; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000523:psychology; D008609:Mental Status Schedule; D018697:Nootropic Agents / Q000627:therapeutic use; D009735:Nursing Homes; D010044:Outpatient Clinics, Hospital; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D011595:Psychomotor Agitation / Q000188:drug therapy / Q000523:psychology; D011619:Psychotropic Drugs / Q000627:therapeutic use*
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D018697:Nootropic Agents; D011619:Psychotropic Drugs
Pharmakotherapie von neuropsychiatrischen Symptomen bei Demenz in Altenpflegeheimen: Ein Vergleich der Versorgung durch psychiatrische Institutsambulanzen und niedergelassene Fachärzte.