Antipsychotic drug use in Canadian long-term care facilities: prevalence, and patterns following resident relocation

• Published in: International psychogeriatrics 2005-06, Vol.17 (2), p.179-193
• Main Authors: Hagen, Brad, Esther, Chris Armstrong, Ikuta, Roland, Williams, Robert J., Le Navenec, Carole-Lynne, Aho, Morgan
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological - drug effects; Addictive behaviors; Adult and adolescent clinical studies; Aged; Aged, 80 and over; Analysis of Variance; Antipsychotic Agents - administration & dosage; Antipsychotics; Biological and medical sciences; Canada - epidemiology; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia - drug therapy; Drug addiction; Humans; Life Change Events; Long term health care; Long-Term Care - psychology; Medical sciences; Neurology; Neuropharmacology; Organic mental disorders. Neuropsychology; Parkinson Disease - drug therapy; Parkinson Disease - epidemiology; Patient Transfer; Pharmacology. Drug treatments; Prescriptions; Prevalence; Psycholeptics: tranquillizer, neuroleptic; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychopharmacology; Psychotropic drugs; Residential Facilities; Stress, Psychological - drug therapy; Stress, Psychological - epidemiology; Stress, Psychological - etiology
• ISSN: 1041-6102; 1741-203X
• DOI: 10.1017/S1041610205001730

Background and aims: Data on antipsychotic use were collected in two Canadian long-term care (LTC) facilities. During the one-year study, residents in one facility were relocated to a new facility, allowing examination of the changes in antipsychotic use associated with relocation. Method: A comparative descriptive design was used. Pharmacy and chart data on antipsychotic use were gathered for three separate one-month periods during one year. Data were collected both in a facility experiencing relocation of all residents to a new facility, and in a facility not undergoing relocation. The three one-month data collection periods covered a one-month period before the relocation, immediately after the relocation, and six months after the relocation. Results: In the facility not experiencing relocation, an average of 31.3% of all residents were receiving antipsychotics. Residents in this facility received antipsychotics for an average length of 0.81 years, and 20.8% of all antipsychotic prescriptions reflected dose reductions within six months of the start of the prescription. Only 8.1% of prescriptions had accompanying documentation on the behavioral indication for the use of antipsychotics. A total of 73.4% of all antipsychotics were ‘atypical’ antipsychotics, and 13.5% of all antipsychotic prescriptions were written as ‘p.r.n.’ (as needed). While the use of antipsychotics remained relatively constant in the non-relocation facility (between 30.3% and 33.1% of all residents), the percentage of residents receiving antipsychotics in the facility experiencing a relocation climbed significantly; from 21.5% six months before the move, to 32.6% immediately after the move, to 36.9% six months after the move. Conclusion: These findings, when compared with the U.S. standards on antipsychotic use (OBRA), suggest the need for additional research on antipsychotic use in Canadian LTC facilities.