Abstract
BackgroundThe prevalence of psychotropic drug (PTD) use in NH residents is high, but few have explored prevalence and persistency in PTD in NH residents and factors associated with persistency. This at the same time as we know that risk of side events may be higher with long- term use in older adults. Thus, the aim of this study was to describe the prevalence and persistence in use of PTD and to explore factors associated with persistence in use of PTD at two consecutive time points in nursing home (NH) residents.MethodsWe included 1163 NH residents in a 72-month longitudinal study with five assessments. Use of PTD, neuropsychiatric symptoms (NPS), severity of dementia and physical health were assessed each time.ResultsThe prevalence over time and persistent use of antipsychotic drugs, antidepressants, anxiolytics and sedatives at two consecutive time points were high in residents with and without dementia. There was an association between greater NPS at the first time point, and persistent use of these drugs, but changes in NPS between time points, did not explain such use. A longer NH stay increased the odds for persistent use of antipsychotics.ConclusionPsychotropic drugs are frequently used as a long-term treatment among NH residents and are associated with severity of neuropsychiatric symptoms, but not with severity of dementia. Closer attention should be paid to follow-up of psychotropic drug treatment, and especially for long –term use of antipsychotics, since the duration of such treatment should be as short as possible.
Highlights
The prevalence of psychotropic drug (PTD) use in nursing home (NH) residents is high, but few have explored prevalence and persistency in PTD in NH residents and factors associated with persistency
In a subsequent analysis where sub-syndrome scores of neuropsychiatric symptoms (NPS) at the first time point were replaced by change in sub-syndrome score between the two assessments, we found no association between change in the subsyndrome scores of NPS and persistent use of antipsychotic drugs, antidepressants, anxiolytics or sedatives
More severe NPS were associated with persistent use of antipsychotics drugs, antidepressants, anxiolytics and sedatives at the time point, but change in NPS between the time points was not associated with persistent use of PTD
Summary
The prevalence of psychotropic drug (PTD) use in NH residents is high, but few have explored prevalence and persistency in PTD in NH residents and factors associated with persistency. This at the same time as we know that risk of side events may be higher with long- term use in older adults. The aim of this study was to describe the prevalence and persistence in use of PTD and to explore factors associated with persistence in use of PTD at two consecutive time points in nursing home (NH) residents. The prevalence of antipsychotic drug use in Scandinavian NH residents with dementia is among the lowest in Europe (pooled estimates 24%) [31]. Antidepressants are the most commonly used PTD in Norwegian NH residents [16, 18, 22]
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