Date: 06 Feb 2008
Frequency and appropriateness of antipsychotic medication use in older people in long-term care
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Many studies have reported excessive use of antipsychotic medications in long stay institutions in Britain and America.
We examined the frequency and appropriateness of antipsychotic prescribing in a variety of extended care settings in the west of Ireland.
Clinical details of 345 residents (211 public and 134 private) were obtained from medication sheets and medical notes and by interviewing nursing staff. American prescribing guidelines were applied for those residents taking antipsychotic medications.
Of the 345 residents, 80 (23%) were prescribed regular antipsychotic medications of whom 41 (51%) were deemed to be receiving these agents inappropriately. There was no difference in the use of antipsychotic drugs (21.3% vs. 26.1%, Chi-sq = 1.1, p = 0.3) between residents of public and private units. However, inappropriate antipsychotic use was more common among those in private care (23/35 (66%) vs. 18/45 (40%); Chi-sq = 5.2, p = 0.02). Prominent inappropriate indications for antipsychotic use were: restlessness (26/41 (63%) patients); history of very intermittent aggression (23 (56%) patients); and wandering (19 (46%) patients).
Inappropriate use of antipsychotic medications, as judged by American legislative guidelines, is common in long-stay units in the west of Ireland.
Ballard C, Cream J (2005) Drugs used to relieve behavioral symptoms in people with dementia or an unacceptable chemical cosh? Int Psychgeriatr 17:12–22CrossRef
Clarke B, McCormack P (2003) Prescribing practices in an Irish long term care setting. Ir Med J 96:203–207PubMed
Omnibus Budget Reconciliation Act of 1987: subtitle C, nursing home reform: PL100-203. Washington, D.C.: National Coalition for Nursing Home Reform, 1987
Nursing home survey procedures and interpretive guidelines (1999) 2nd edn. Alexandria, : American Society of Consultant Pharmacists
Furniss L, Burns A, Craig SK, Scobie S, Cooke J, Faragher B (2000) Effects of a pharmacist’s medication review in nursing homes. Br J Psych 176:563–567CrossRef
Hermann N, Lanctot KL (2005) Do atypical antipsychotics cause stroke? CNS Drugs 19:91–103CrossRef
Lantz MS, Giambanco V, Buchalter EN (1996) A ten-year review of the effect of OBRA87 on psychotropic prescribing practices in an academic nursing home. Psychiatr Serv 47:951–955PubMed
- Frequency and appropriateness of antipsychotic medication use in older people in long-term care
Irish Journal of Medical Science
Volume 177, Issue 1 , pp 35-37
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