Prevalence and persistent use of psychotropic drugs in older adults receiving domiciliary care at baseline
Open accessAbstract
BACKGROUND: Little is known about the use of psychotropic drugs in older adults receiving domiciliary care. The first aim was to describe the prevalence and persistency of use of psychotropic drugs in older adults (≥ 70 years) with and without dementia receiving domiciliary care. Furthermore, the second aim was to explore factors associated with persistent drug use at two consecutive time-points. Lastly, we aimed to examine if use of psychotropic drugs changed after admission to a nursing home. METHODS: In total, 1001 community-dwelling older adults receiving domiciliary care at inclusion participated in the study. Information about psychotropic drug use was collected at baseline, after 18 months and after 36 months. The participants' cognitive function, neuropsychiatric symptoms (NPS) and physical health were assessed at the same assessments. Participants were evaluated for dementia based on all gathered information. Formal level of care (domiciliary care or in a nursing home) was registered at the follow-up assessments. RESULTS: Prevalence and persistent use of psychotropic drugs in older adults receiving domiciliary care was high. Participants with dementia more often used antipsychotics and antidepressants than participants without dementia. The majority of the participants using antipsychotic drugs used traditional antipsychotics. Younger age was associated with higher odds for persistent use of antipsychotics and antidepressants, and lower odds for persistent use of sedatives. Severity of NPS was associated with persistent use of antidepressants. The odds for use of antipsychotics and antidepressants were higher in those admitted to a nursing home as compared to the community-dwelling participants at the last follow-up. CONCLUSION: There was a high prevalence and persistency of use of psychotropic drugs. The prevalence of use of traditional antipsychotics was surprisingly high, which is alarming. Monitoring the effect and adverse effects of psychotropic drugs is an important part of the treatment, and discontinuation should be considered when possible due to the odds for severe adverse effects of such drugs in people with dementia.
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Despite guidelines, some psychotropics are used far longer than recommended or without appropriate, documented reasons.
“Despite this, some psychotropics are used far longer than recommended or without appropriate, documented reasons [29–31].”
From Stakeholders' views on the use of psychotropic medication in older people: a systematic review (2022) · cites this paper as [29]
The Results (Persistent use of psychotropic drugs; page unavailable) report high persistent use, and the Discussion (Use of antipsychotics; page unavailable) says antipsychotics should be used only briefly in people with dementia yet were often used at consecutive assessments. The paper does not establish that prescriptions lacked appropriate, documented reasons. (LLM, conf=0.85)
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- Authors
- Lornstad, M. T., Aarøen, M., Bergh, S., Benth, J. Š., & Helvik, A.-S.
- Affiliations
- Norwegian University of Science and Technology (NO)
- Innlandet Hospital Trust (NO)
- University of Oslo (NO)
- Corresponding author
- Lornstad, Marie Turmo
- Venue
- BMC Geriatrics
- Published
- 2019-04-25
- Volume
- 19
- Issue
- 1
- Pages
- 119-119
- ISSN
- 1471-2318 (ISSN-L)
- PMC
- PMC6485106
- OpenAlex
- W2946407398
- Cited by
- 24
- References
- 76
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 3 · 2022: 6 · 2021: 8 · 2020: 2 · 2019: 1
- FWCI
- 2.24
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Geriatrics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- Funders
- Norwegian Directorate of Health (None)
- Innlandet Hospital Trust (None)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- psychotropic drugs, older adults, home care, dementia, antipsychotic drugs, antidepressants, sedatives, neuropsychiatric symptoms, nursing home admission, treatment persistence, adverse drug reactions
- MeSH terms
- Aged, Aged, 80 and over, Cognition, Dementia, Female, Follow-Up Studies, Home Care Services, Humans, Longitudinal Studies, Male, Nursing Homes, Psychotropic Drugs, Skilled Nursing Facilities, Prevalence
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