An observational study of psychotropic drug use and initiation in older patients resident in their own home or in care

• Published in: Age and ageing 2013-01, Vol.42 (1), p.51-56
• Main Authors: McCowan, Colin, Magin, Parker, Clark, Stella Anne, Guthrie, Bruce
• Format: Article
• Language: English
• Subjects: Admissions; Aged; Aged, 80 and over; Antipsychotic drugs; Dosage and administration; Drug therapy; Family physicians; Female; Home health care; Homes for the Aged; Humans; In care; Inappropriate Prescribing; Logistic Models; Male; Nursing home patients; Observation; Older people; Patient outcomes; Patient Safety; Practice Patterns, Physicians' - statistics & numerical data; Prescriptions; Psychotropic drugs; Psychotropic Drugs - classification; Psychotropic Drugs - therapeutic use; Residential care; Retrospective Studies; Scotland; State Medicine
• ISSN: 0002-0729; 1468-2834
• DOI: 10.1093/ageing/afs117

to compare the prescription of psychotropic medications for patients living in care homes with that for patients living at home. retrospective population database study in the Tayside region of Scotland. 70,297 patients aged ≥65 and followed until death or the end of the study. examining registered addresses for all people aged 65-99 identified those in care. The prescriptions for a 12-week period was examined and psychotropic drug use compared by their place of residence. Comparisons of prescriptions pre- and post-admission were performed for people admitted to a care home from Jan 2005 to Dec 2006. people living in care (4.1%) received 9.80 more prescribed items (P < 0.001) from 1.63 more British National Formulary (BNF) categories (P < 0.001) than people living at home over a 12-week period. They were more likely to receive any psychotropic medication (42 versus 16%, odds ratio (OR) 3.09, 95% CI: 2.79-3.41). Over 70% of 1,715 people admitted to care homes during the study who received psychotropic medication commenced the medication prior to admission. Patients who started anti-psychotics in the 30 days prior to admission were less likely to have stopped them (OR: 0.53, 95% CI: 0.30-0.94). prolonged prescription of psychotropic medications is commonplace in care home residents. Almost half of the people prescribed antipsychotic drugs received them for a minimum of 6 months. Systematic medication reviews must be established in all care homes to promote safe and effective prescription to this at-risk population.