title: Associated factors with antipsychotic use in long-term institutional care in eight European countries: Results from the RightTimePlaceCare study.
abstract: OBJECTIVE
  To determine factors associated with the antipsychotic (AP) prescription for people with dementia (PwD) recently admitted to institutional long-term care facilities (LTCFs) and to ascertain differences in the use of this medication in 8 European countries.
  
  
  METHODS
  An exploratory cross-sectional study.
  
  
  METHODS
  LTCFs from 8 European countries (Estonia, Finland, France, Germany, The Netherlands, Spain, Sweden, and England).
  
  
  METHODS
  A total of 791 PwD recently admitted to an LTCF and their caregivers.
  
  
  METHODS
  Baseline data from RightTimePlaceCare survey was used. Patients' medical conditions, neuropsychiatric symptoms, physical and cognitive status, and medications were recorded. Multiple logistic regression models were used to assess associations with the AP use.
  
  
  RESULTS
  A group of 296 patients (37.4%) of 791 patients recently admitted received AP medication. The prevalence of the use of 1 or more APs varied between study countries, ranging from 12% in Sweden to 54% in Spain. Factors independently associated with the AP use were living in Sweden [odds ratio (OR) 0.12, 95% confidence interval (CI) 0.05-0.30], Finland (OR 0.26, 95% CI 0.14-0.48), Germany (OR 2.75, 95% CI 1.55-4.86) and Estonia (OR 6.79, 95% CI 3.84-12.0). The odds of AP use decreased with the presence of a dementia specific unit in the LTCF (OR 0.60, 95% CI 0.39-0.92), but was higher among residents with a hyperactivity behavior (OR 2.12, 95% CI 1.41-3.18).
  
  
  CONCLUSIONS
  The current study shows that more than one-third of the residents recently admitted received APs and that prescription frequency across countries varied significantly. This study raises the possibility that the presence of a dementia-specific unit might play a role in the AP use. Further studies should investigate this association and seek better understanding of what will achieve optimal quality of AP use among newly admitted residents in LTCF.
authors.affiliation: Department of Geriatric Medicine, Gerontopole, Toulouse University Hospital, INSERM 1027, Toulouse, France.
authors.forename: Adelaide
authors.initials: A
authors.lastname: de Mauleon
authors.affiliation: Department of Geriatric Medicine, Gerontopole, Toulouse University Hospital, INSERM 1027, Toulouse, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Sourdet
authors.affiliation: Institut fuer Allgemeinmedizin und Familienmedizin, Universitaet Witten/Herdecke, Witten, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Renom-Guiteras
authors.affiliation: Department of Geriatric Medicine, Gerontopole, Toulouse University Hospital, INSERM 1027, Toulouse, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Gillette-Guyonnet
authors.affiliation: Department of Nursing Science, University of Turku, Turku, Finland.
authors.forename: Helena
authors.initials: H
authors.lastname: Leino-Kilpi
authors.affiliation: Department of Health Sciences, Lund University, Lund, Sweden.
authors.forename: Staffan
authors.initials: S
authors.lastname: Karlsson
authors.affiliation: Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.
authors.forename: Michel
authors.initials: M
authors.lastname: Bleijlevens
authors.affiliation: Hospital Clinic de Barcelona, Barcelona, Spain.
authors.forename: Adela
authors.initials: A
authors.lastname: Zabategui
authors.affiliation: Department of Internal Medicine, University of Tartu, Tartu, Estonia.
authors.forename: Kai
authors.initials: K
authors.lastname: Saks
authors.affiliation: Department of Geriatric Medicine, Gerontopole, Toulouse University Hospital, INSERM 1027, Toulouse, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Vellas
authors.affiliation: Personal Social Services Research Unit, University of Manchester, Manchester, UK.
authors.forename: David
authors.initials: D
authors.lastname: Jolley
authors.affiliation: Department of Geriatric Medicine, Gerontopole, Toulouse University Hospital, INSERM 1027, Toulouse, France. Electronic address: soto-martin.me@chu-toulouse.fr.
authors.forename: Maria
authors.initials: M
authors.lastname: Soto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000188:drug therapy*; D004363:Drug Utilization; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes
chemical_list: D014150:Antipsychotic Agents
keywords: Dementia; antipsychotic; elderly; nursing home