Background: The aim of the study was to examine whether staff distress and aspects of the nursing home environment were associated with psychotropic drug use (PDU) in patients with dementia.
Methods: This was a cross-sectional study of 1289 nursing home patients with dementia from 56 Dementia Special Care Units (SCUs) in the Netherlands. The primary outcome was PDU. Potential correlates of PDU were staff distress, environmental correlates (the number of patients per unit or per living room, staff/patient ratio, and the presence of a walking circuit), and patient factors (gender, age, dementia severity, and neuropsychiatric symptoms (NPS)). Multilevel logistic regression analysis was used to estimate the relative contributions of predictor variables in explaining PDU.
Results: Staff distress, aspects of the physical nursing home environment and patients' neuropsychiatric symptoms were independently associated with PDU. Staff distress at patients' agitation was associated with antipsychotic and anxiolytic drug use (OR 1.66, 95% CI (1.16-2.36) and 1.62 (1.00-2.61), respectively). SCUs with more patients per living room had higher hypnotic drug use (OR 1.08, 95% CI (1.02-1.14)). Low staff/patient ratio was associated with high antidepressant drug use (OR 0.13, 95% CI (0.04-0.47)). The effects of nursing home environment on study outcome were smallest for antidepressant use (intra-SCU correlation 0.005) and highest for hypnotic use (intra-SCU correlation 0.171).
Conclusion: Staff distress and other environmental aspects are independently associated with PDU. These findings raise questions about the appropriateness of psychoactive drug prescriptions for nursing home patients with dementia.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1017/S1041610211001438 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Psychosocial situation, burden, and unmet needs among informal caregivers prior to hematopoietic stem cell transplantation: a systematic review of quantitative and qualitative data.
Support Care Cancer
January 2025
Nursing Department, The Third Xiangya Hospital, Central South University, No. 138 Tongzipo Road, Yuelu District, Hexi District, Changsha, Hunan, China.
Background: Informal caregivers may face challenges, especially during the pre-transplant phase. We have learned about the challenges faced by informal caregivers during hematopoietic stem cell transplantation; there is a lack of consensus about the challenges faced by them before transplantation. We identified the psychosocial well-being of informal caregivers to patients before hematopoietic stem cell transplantation.
View Article and Find Full Text PDFPsychotropic Polypharmacy in Dementia: A Retrospective Analysis for People with Neuropsychiatric Symptoms Referred to an Australian Dementia Support Service.
Drugs Aging
January 2025
The Dementia Centre, HammondCare, St Leonards, NSW, Australia.
Background And Objectives: Despite their limited benefits and serious adverse effects, psychotropics remain frequently prescribed for neuropsychiatric symptoms (NPS) of dementia. Psychotropic polypharmacy, the use of two or more concomitant psychotropic medications, is therefore not recommended for people with dementia. The objectives of this study were to investigate the prevalence of psychotropic polypharmacy in Australians living with dementia whose caregivers sought external NPS support from Dementia Support Australia (DSA; the national provider of NPS support) and the association of psychotropic polypharmacy with their demographics and NPS characteristics.
View Article and Find Full Text PDFClose to the border-Resilience in healthcare in a European border region: Findings of a needs analysis.
PLoS One
January 2025
Department of Anesthesiology, University Hospital RWTH Aachen, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Objectives: Promoting resilience, the ability to withstand and overcome challenging situations, is crucial for maintaining the performance of healthcare systems. Unique challenges faced by healthcare facilities in border regions render them particularly vulnerable during crises, emphasizing the need to promote resilience in these areas. The current study evaluated the state and needs of resilience in healthcare professionals in a representative European border region.
View Article and Find Full Text PDFA Systematic Review of International Bereavement Models of Care and Implementation Barriers and Facilitators.
Omega (Westport)
January 2025
Psycho-oncology Co-operative Research Group, School of Psychology, The University of Sydney, Camperdown, NSW, Australia.
Bereavement care can facilitate adjustment to death and reduce immediate distress and long-term morbidity, mortality and health service utilisation. This systematic review aimed to identify international models of bereavement care, and barriers and facilitators to implementing such models. A systematic search of MEDLINE, Embase, CINAHL and PsycINFO identified 64 studies for inclusion.
View Article and Find Full Text PDFDelirium prevention in hospices: Opportunities and limitations - A focused ethnography.
Palliat Med
January 2025
Department of Health Sciences, University of York, York, UK.
Background: Delirium is common and distressing for hospice in-patients. Hospital-based research shows delirium may be prevented by targeting its risk factors. Many preventative strategies address patients' fundamental care needs.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!