title: A quality improvement initiative on the use of psychotropic drugs in nursing homes in Flanders.
abstract: BACKGROUND
  Government-funded quality improvement projects aimed to reduce the high psychotropic medication use in Belgian long-term care settings.
  
  
  METHODS
  A pilot project (2013-2014) with a pre-post and follow-up intervention design.
  
  
  METHODS
  Two nursing homes received three educational courses. In the intervention nursing home (INH) additionally, a transition towards person-centred care through professional support was applied. Drug use was recorded at baseline, after 10 months (post) and after 22 months (follow-up), and coded into the Anatomical Therapeutic Chemical classification.
  
  
  RESULTS
  At baseline, the INH residents' (n = 118) mean age at baseline was 82 years, with 71% females. The control nursing home residents' (CNH, n = 275) mean age was 82.7 years, with 75% females. At baseline, mean drug use was 9 (range 1-21) and 8 (range 0-20), predominantly with a high proportion of psychotropic drug users of 73 and 65%, in INH and CNH respectively. At the time of post-measurement, only the proportion of hypno-sedative users decreased significantly in the INH (by 13%, p = 0.048). No significant changes were found in the CNH. At time of the follow-up, the proportion of hypno-sedative (51% vs. 31%; p = 0.005) and antidepressant users (42% vs. 25%, p = 0.007) decreased significantly in the INH. The decrease of antipsychotic drug users was less distinct. In the CNH, the proportion of hypno-sedative, antidepressant and overall psychotropic drug users did not change significantly.
  
  
  CONCLUSIONS
  This quality improvement initiative led to a significant decrease in the use of psychotropic drugs in the INH, even after 1-year follow-up. Education only had a limited effect.
authors.affiliation: a Heymans Institute of Pharmacology, Clinical Pharmacology Research Unit , Ghent University , Ghent , Belgium.
authors.forename: Majda
authors.initials: M
authors.lastname: Azermai
authors.affiliation: a Heymans Institute of Pharmacology, Clinical Pharmacology Research Unit , Ghent University , Ghent , Belgium.
authors.forename: Maarten
authors.initials: M
authors.lastname: Wauters
authors.affiliation: b Nursing Home Leiehome , Drongen , Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: De Meester
authors.affiliation: b Nursing Home Leiehome , Drongen , Belgium.
authors.forename: Lisa
authors.initials: L
authors.lastname: Renson
authors.affiliation: b Nursing Home Leiehome , Drongen , Belgium.
authors.forename: Danny
authors.initials: D
authors.lastname: Pauwels
authors.affiliation: b Nursing Home Leiehome , Drongen , Belgium.
authors.forename: Laurine
authors.initials: L
authors.lastname: Peeters
authors.affiliation: b Nursing Home Leiehome , Drongen , Belgium.
authors.forename: Hans
authors.initials: H
authors.lastname: Warie
authors.affiliation: c Department of Internal Medicine, Section of Geriatrics , Ghent University , Ghent , Belgium.
authors.forename: Mirko
authors.initials: M
authors.lastname: Petrovic
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001530:Belgium; D065187:Controlled Before-After Studies; D005260:Female; D006282:Health Personnel / Q000193:education*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D018802:Patient-Centered Care; D010865:Pilot Projects; D010818:Practice Patterns, Physicians'; D011619:Psychotropic Drugs / Q000627:therapeutic use; D058996:Quality Improvement
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives; D011619:Psychotropic Drugs
keywords: Aged; Medication; Nursing home; Psychotropic drugs; Quality improvement