title: Prescribing pattern of psychotropic drugs in nursing home residents with dementia.
abstract: BACKGROUND
  The goal of this study is to determine patterns of psychotropic drug use (PDU), the association with neuropsychiatric symptoms (NPS), and the variability across dementia types in nursing home residents with dementia. In addition, PDU was analyzed across multiple indications.
  
  
  METHODS
  This was a prospective cohort study over a two-year period from 2006 to 2008, which involved 14 dementia special care units in nine nursing homes. A total of 117 residents with dementia participated in the study, of whom 35% had Alzheimer's dementia (AD) and 11% vascular dementia (VaD). PDU was classified according to anatomical therapeutic chemical-classification as either "present" or "absent".
  
  
  RESULTS
  The majority of residents had moderately severe to severe dementia. At all successive assessments, almost two-thirds of residents received any psychotropic drug (PD) and almost one-third continued to receive any PD. Of all PDs, antipsychotics (APs) were prescribed most frequently. Fewer residents started with antidepressants, but continued to receive antidepressants at higher percentages. Anxiolytics showed an intermittent course, but a subgroup of 9% showed two-year continuation. Once started on PDs at baseline, residents continued to use PDs at high percentages: three-quarters continued to receive APs for at least six months. Half of residents received at least one PD; one-fifth received at least two PDs simultaneously. Residents with AD received more hypnotics and antidementia drugs; residents with VaD received more antipsychotics, antidepressants, anxiolytics and anticonvulsants.
  
  
  CONCLUSIONS
  PDs have different utilization patterns, but overall, consistently high continuation rates were found. These results warrant scrutiny of continuous PDU.
authors.affiliation: Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands. r.wetzels@elg.umcn.nl
authors.forename: R B
authors.initials: RB
authors.lastname: Wetzels
authors.forename: S U
authors.initials: SU
authors.lastname: Zuidema
authors.forename: J F M
authors.initials: JF
authors.lastname: de Jonghe
authors.forename: F R J
authors.initials: FR
authors.lastname: Verhey
authors.forename: R T C M
authors.initials: RT
authors.lastname: Koopmans
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003704:Dementia / Q000188:drug therapy*; D015140:Dementia, Vascular / Q000188:drug therapy; D005260:Female; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D061212:Memory, Episodic; D009426:Netherlands; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012720:Severity of Illness Index
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives; D011619:Psychotropic Drugs