A retrospective, longitudinal study of factors associated with new antipsychotic medication use among recently admitted long-term care residents

TitleA retrospective, longitudinal study of factors associated with new antipsychotic medication use among recently admitted long-term care residents
Publication TypeJournal Article
Year of Publication2015
AuthorsFoebel A., Ballokova A., Wellens N.I, Fialova D., Milisen K., Liperoti R., Hirdes J.P
JournalBMC Geriatr
Volume15
Pagination128
Date PublishedOct 19
ISBN Number1471-2318 (Electronic)<br/>1471-2318 (Linking)
Accession Number26482028
KeywordsAged, Antipsychotic Agents/ therapeutic use, Dementia/drug therapy/epidemiology/psychology, Female, Follow-Up Studies, Humans, Long-Term Care/ psychology/ trends, Longitudinal Studies, Male, Nursing Homes/ trends, Ontario/epidemiology, Patient Admission/ trends, Psychomotor Agitation/drug therapy/epidemiology/psychology, Retrospective Studies
Abstract

BACKGROUND: Use of antipsychotic (AP) medications is high and often inappropriate among institutionalized populations. Little is known about the correlates of new AP drug use following admission to long-term care (LTC) settings. This study investigated the frequency and correlates of new AP drug use among newly admitted LTC residents. METHODS: This longitudinal, retrospective study used data from the interRAI - Nursing Home Minimum Data Set version 2.0 (MDS 2.0) instrument. Data about demographic, clinical and social characteristics, and medication use, were collected in Ontario, Canada, from 2003-2011 by trained nurses. Residents with complete admission and 3-6 month follow-up data were included (N = 47,768). Multivariate logistic regression analyses, stratified by gender, explored correlates of new AP drug use upon admission to LTC. RESULTS: New AP drug users comprised 7 % of the final cohort. Severe cognitive impairment, dementia, and motor agitation were significantly associated with new AP drug use among both sexes. Additionally, behavioural problems, conflicts with staff and reduced social engagement were strong correlates of new AP drug use. CONCLUSIONS: Social factors were as strongly associated with new AP drug use after LTC admission as clinical factors. Strategies to prevent the potential misuse of AP drugs upon LTC admission should consider the social determinants of such prescribing.

DOI10.1186/s12877-015-0127-8
Short TitleBMC geriatricsBMC geriatrics
Alternate JournalBMC geriatrics