title: Factors related to psychotropic drug prescription for neuropsychiatric symptoms in nursing home residents with dementia.
abstract: OBJECTIVE
  The objective of this study is to explore factors that elucidate reasons for psychotropic drug (PD) prescription for neuropsychiatric symptoms (NPS) in nursing home (NH) residents with dementia.
  
  
  METHODS
  A qualitative study using a grounded theory approach.
  
  
  METHODS
  Twelve NHs in The Netherlands.
  
  
  METHODS
  Fifteen physicians and 14 nurses.
  
  
  METHODS
  Individual, face-to-face, in-depth semistructured interviews. Interviews were audio recorded, transcribed, and qualitatively analyzed using Atlas.ti.
  
  
  RESULTS
  The qualitative analysis revealed 4 emerging themes with factors either or both enhancing or limiting PD prescription, which we used to develop a conceptual framework. First, the mindset of physicians and nurses toward NPS and PDs appeared to contribute. Second, inadequate knowledge of and experience with NPS and limited people skills of nurses may induce PD prescription. Also, knowledge of effectiveness and side effects of PDs from education, literature, and guidelines, and previous personal experiences was considered relevant. Third, effective communication and cooperation between professionals and with family may improve the appropriateness of PD prescription. Fourth, external factors including staffing issues, nursing home setting, access to consultants, national and local policies, and zeitgeist were considered to affect PD prescription.
  
  
  CONCLUSIONS
  We have developed a conceptual framework explaining how different factors influence PD prescription. This provides opportunities for improving PD prescription in NH residents with dementia.
authors.affiliation: Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: claudia.smeets@radboudumc.nl.
authors.forename: Claudia H W
authors.initials: CH
authors.lastname: Smeets
authors.affiliation: Department of General Practice and Elderly Care Medicine/EMGO + Institute for Health and Care Research, VU Medical Center, Amsterdam, The Netherlands.
authors.forename: Martin
authors.initials: M
authors.lastname: Smalbrugge
authors.affiliation: Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Sytse U
authors.initials: SU
authors.lastname: Zuidema
authors.affiliation: Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Els
authors.initials: E
authors.lastname: Derksen
authors.affiliation: Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Erica
authors.initials: E
authors.lastname: de Vries
authors.affiliation: Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Klaas
authors.initials: K
authors.lastname: van der Spek
authors.affiliation: Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Center, Nijmegen, The Netherlands; Joachim en Anna, Center for Specialized Geriatric Care, Nijmegen, The Netherlands.
authors.forename: Raymond T C M
authors.initials: RT
authors.lastname: Koopmans
authors.affiliation: Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: debby.gerritsen@radboudumc.nl.
authors.forename: Debby L
authors.initials: DL
authors.lastname: Gerritsen
mesh_terms: D003704:Dementia / Q000188:drug therapy*; D006801:Humans; D007407:Interviews as Topic; D009426:Netherlands; D009726:Nurses / Q000523:psychology; D009735:Nursing Homes; D010820:Physicians / Q000523:psychology; D010818:Practice Patterns, Physicians'; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D036301:Qualitative Research
chemical_list: D011619:Psychotropic Drugs
keywords: Dementia; nursing homes; psychotropic drugs