Psychotropic Drug Prescription in Patients with Dementia: Nursing Home Residents Versus Patients Living at Home.
BACKGROUND
Psychotropic drugs are frequently prescribed in nursing homes (NH). Nonetheless, we hoped that institutionalization decreases the number of psychotropic drug classes prescribed, because NH residents may have more psychosocial interventions than patients living at home.


OBJECTIVE
The aim was to compare the type and number of psychotropic drugs prescribed in elderly NH residents with dementia with those in community-living patients.


METHODS
This cross-sectional study included elderly patients (at least 75 years old) with dementia recorded in the National Alzheimer's data Bank ("Banque Nationale Alzheimer") during the year 2012 and who were taking at least one psychotropic drug. Psychotropic drugs were classified as follows: antidepressant, anxiolytic, hypnotic, and antipsychotic drugs. Patients were classified into three categories of dementia severity according to the MMSE score.


RESULTS
Among the 50,932 patients with dementia recorded in the BNA, 40.1% had at least one psychotropic drug prescribed. Most of the patients who were treated by at least one psychotropic drug class had antidepressant therapy (69.0%), whatever their residence type, and 16.1% were treated with antipsychotics. Among the study population, 51.9% of the NH residents and 67.4% of the patients living at home had only one psychotropic drug class prescribed. Living in a NH was significantly associated with the more frequent prescription of anxiolytic, hypnotic, and antipsychotic drugs, and with a greater number of psychotropic drug classes prescribed, whatever the severity of the dementia.


CONCLUSIONS
We underlined the more frequent prescription of psychotropic drugs in NH residents regardless of MMSE scores.
University Hospital of Dijon, Centre Mémoire de Ressources et de Recherches, Department of Neurology, Dijon, France.
Agnès
A
Jacquin-Piques
Centre Mémoire de Ressource et de Recherche, EA CoBTeK, Université de Nice Sophia-Antipolis, Nice, France.
Guillaume
G
Sacco
Gérontopôle de Toulouse, Département de Médecine Interne et Gérontologie Clinique, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
Neda
N
Tavassoli
University Hospital of Dijon, Centre Mémoire de Ressources et de Recherches, Department of Neurology, Dijon, France.
Olivier
O
Rouaud
University Hospital of Dijon, Centre Mémoire de Ressources et de Recherches, Department of Neurology, Dijon, France.
Yannick
Y
Bejot
University Hospital of Dijon, Centre Mémoire de Ressources et de Recherches, Department of Neurology, Dijon, France.
Maurice
M
Giroud
Centre Mémoire de Ressource et de Recherche, EA CoBTeK, Université de Nice Sophia-Antipolis, Nice, France.
Philippe
P
Robert
Gérontopôle de Toulouse, Département de Médecine Interne et Gérontologie Clinique, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
Bruno
B
Vellas
University Hospital AP-HM, Department of Internal Medicine and Geriatrics, Aix Marseille University, Marseille, France.
Sylvie
S
Bonin-Guillaume
D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D016208:Databases, Factual / Q000706:statistics & numerical data; D003704:Dementia / Q000188:drug therapy* / Q000453:epidemiology*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012111:Residence Characteristics
D011619:Psychotropic Drugs
Dementia; National Alzheimer’s data Bank; nursing home; psychotropic drug