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Changes to psychotropic medications in the six months after admission to nursing homes in Melbourne, Australia

Published online by Cambridge University Press:  04 March 2010

Daniel W. O'Connor ,
Joanne Griffith  and
Kate McSweeney
Daniel W. O'Connor*
Affiliation:
Aged Mental Health Research Unit, School of Psychology and Psychiatry, Monash University, Melbourne, Australia
Joanne Griffith
Affiliation:
Aged Mental Health Research Unit, School of Psychology and Psychiatry, Monash University, Melbourne, Australia
Kate McSweeney
Affiliation:
Aged Mental Health Research Unit, School of Psychology and Psychiatry, Monash University, Melbourne, Australia
*
Correspondence should be addressed to: Daniel O'Connor, Professor of Old Age Psychiatry, Kingston Centre, Warrigal Road, Cheltenham, Victoria 3192, Australia. Phone: +613 9265-1700; Fax: +613 9265-1711. Email: [email protected].
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Abstract

Background: Nursing home residents are often prescribed large numbers of psychotropic medications. Previous studies suggest that antipsychotic medications are often unnecessary and can be withdrawn without ill effects. Depression, in contrast, is believed to be under-recognized and under-treated.

Method: A six-month audit was carried out of the antipsychotic, antidepressant, anxiolytic and hypnotic medications prescribed to 166 newly admitted residents of a convenience sample of seven nursing homes in Melbourne, Australia.

Results: Over the six-month period, antidepressants were started in 6% of all cases and stopped in 2% of treated cases. Antipsychotics were added in 5% of all cases and stopped in 15% of treated cases. Residents were switched from one antidepressant to another in 5% of treated cases and from one antipsychotic to another in 4%. Benzodiazepine use was relatively modest.

Conclusions: Judging from epidemiological data, treatment revisions were almost certainly insufficient to address residents’ mental health needs. We discuss ways of harnessing existing nursing and pharmacy resources to ensure better care for aged residents.

Keywords

Antipsychoticantidepressantbenzodiazepineprescribingnursing homes
Type
Research Article
Information
International Psychogeriatrics , Volume 22 , Special Issue 7: Focus on mental health issues in long-term-care homes , November 2010 , pp. 1149 - 1153
Copyright
Copyright © International Psychogeriatric Association 2010

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