Antidepressant prescribing patterns in the nursing home: second-generation issues revisited.
BACKGROUND
The object of this study was to provide an updated evaluation of the quality of antidepressant management and prescribing patterns in nursing homes in the context of organizational and resident factors.


METHODS
Pearson correlation and chi-square analyses were conducted using information gathered from random nursing home charts.


METHODS
Nursing home facilities in and around the Louisville, KY, metropolitan area (n = 10).


METHODS
Chart reviews were randomly chosen for 20% of long term care resident records in participating homes (n = 209).


METHODS
Demographic information, documentation of depression diagnoses, and antidepressant prescribing patterns were evaluated using the Quality of Depression Management and Antidepressant Prescribing rating scale and information found in the Minimum Data Set 2.0.


RESULTS
Of the sample, 59.8% was prescribed antidepressants at the time of the chart review; 205 chart reviews indicated the absence or presence of a depression diagnosis. For those with documented depression diagnoses (n = 126), nearly one-quarter were not prescribed antidepressants. Of 79 chart reviews indicating no depression diagnosis, nearly a third were receiving an antidepressant. Documentation related to changes in dosing, the presence or absence of side effects, or reasons for continuation were suboptimal.


CONCLUSIONS
Discrepancy between antidepressant prescribing and the presence/absence of depression diagnoses continue to exist for nursing home residents. The quality of antidepressant documentation in nursing home charts continues to be inadequate. Future research should aim to explore possible solutions to these discrepancies and deficiencies in documentation.
Department of Psychological & Brain Sciences, University of Louisville, Louisville, KY 40292, USA.
Shruti
S
Shah
Ben
B
Schoenbachler
Joel
J
Streim
Suzanne
S
Meeks
D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D016208:Databases, Factual; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D004282:Documentation / Q000639:trends*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D015577:Geriatric Assessment; D006707:Homes for the Aged / Q000706:statistics & numerical data; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D020380:Needs Assessment; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014481:United States
D000928:Antidepressive Agents