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Antipsychotic drug use among elderly nursing home residents in the United States.
Am J Geriatr Pharmacother. 2008 Oct; 6(4):187-97.AJ

Abstract

BACKGROUND

Antipsychotic utilization in elderly nursing home residents has increased substantially in recent years, primarily due to the use of atypical antipsychotic agents. However, few studies have examined antipsychotic utilization patterns in nursing home residents in the United States since the introduction of atypical agents in the 1990s.

OBJECTIVE

The goal of this study was to examine the prevalence of and the factors associated with antipsychotic drug use among elderly nursing home residents in the United States.

METHODS

This study involved a cross-sectional analysis of prescription and resident data files from the 2004 National Nursing Home Survey (NNNHS). The analysis focused on the use of 11 typical and 6 atypical antipsychotic agents among a nationally representative sample of elderly patients (aged > or =65 years). Descriptive weighted analysis was performed to examine antipsychotic prevalence patterns. Multiple logistic regression analysis within the conceptual framework of the Andersen behavioral model was used to examine the factors associated with antipsychotic drug use among the elderly nursing home residents.

RESULTS

According to the 2004 NNHS, 0.32 million elderly nursing home residents received antipsychotic medications, for an overall prevalence of 24.82%. Most received atypical agents (23.45%), while 1.90% received typical agents. Frequently reported diagnoses among the elderly using an antipsychotic agent were dementia (70%), depression (41%), and anxiety (18%). Among the predisposing characteristics, female gender and age (> or =85 years) were negatively associated with antipsychotic drug use. Need factors such as increasing dependence in decision-making ability regarding tasks of daily life, depressed mood indicators, behavioral symptoms, history of falls, and bowel incontinence were positively associated with antipsychotic drug use. In addition to the use of antipsychotic agents in schizophrenia and bipolar mania, this study found high use in conditions such as dementia, anxiety, depression, and parkinsonism in the elderly.

CONCLUSIONS

Nearly 1 in 4 elderly nursing home residents in the United States received antipsychotic agents. Predisposing and need factors played a vital role in determining the use of antipsychotic agents in these elderly patients. Overall, the study findings suggest that there is a need to monitor antipsychotic drug use by elderly patients in US nursing homes in light of recent efficacy and safety data on atypical agents.

Authors+Show Affiliations

Department of Clinical Sciences and Administration, College of Pharmacy, University of Houston, Houston, Texas 77030, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19028374

Citation

Kamble, Pravin, et al. "Antipsychotic Drug Use Among Elderly Nursing Home Residents in the United States." The American Journal of Geriatric Pharmacotherapy, vol. 6, no. 4, 2008, pp. 187-97.
Kamble P, Chen H, Sherer J, et al. Antipsychotic drug use among elderly nursing home residents in the United States. Am J Geriatr Pharmacother. 2008;6(4):187-97.
Kamble, P., Chen, H., Sherer, J., & Aparasu, R. R. (2008). Antipsychotic drug use among elderly nursing home residents in the United States. The American Journal of Geriatric Pharmacotherapy, 6(4), 187-97. https://doi.org/10.1016/j.amjopharm.2008.10.002
Kamble P, et al. Antipsychotic Drug Use Among Elderly Nursing Home Residents in the United States. Am J Geriatr Pharmacother. 2008;6(4):187-97. PubMed PMID: 19028374.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antipsychotic drug use among elderly nursing home residents in the United States. AU - Kamble,Pravin, AU - Chen,Hua, AU - Sherer,Jeff, AU - Aparasu,Rajender R, PY - 2008/07/25/accepted PY - 2008/11/26/pubmed PY - 2009/1/23/medline PY - 2008/11/26/entrez SP - 187 EP - 97 JF - The American journal of geriatric pharmacotherapy JO - Am J Geriatr Pharmacother VL - 6 IS - 4 N2 - BACKGROUND: Antipsychotic utilization in elderly nursing home residents has increased substantially in recent years, primarily due to the use of atypical antipsychotic agents. However, few studies have examined antipsychotic utilization patterns in nursing home residents in the United States since the introduction of atypical agents in the 1990s. OBJECTIVE: The goal of this study was to examine the prevalence of and the factors associated with antipsychotic drug use among elderly nursing home residents in the United States. METHODS: This study involved a cross-sectional analysis of prescription and resident data files from the 2004 National Nursing Home Survey (NNNHS). The analysis focused on the use of 11 typical and 6 atypical antipsychotic agents among a nationally representative sample of elderly patients (aged > or =65 years). Descriptive weighted analysis was performed to examine antipsychotic prevalence patterns. Multiple logistic regression analysis within the conceptual framework of the Andersen behavioral model was used to examine the factors associated with antipsychotic drug use among the elderly nursing home residents. RESULTS: According to the 2004 NNHS, 0.32 million elderly nursing home residents received antipsychotic medications, for an overall prevalence of 24.82%. Most received atypical agents (23.45%), while 1.90% received typical agents. Frequently reported diagnoses among the elderly using an antipsychotic agent were dementia (70%), depression (41%), and anxiety (18%). Among the predisposing characteristics, female gender and age (> or =85 years) were negatively associated with antipsychotic drug use. Need factors such as increasing dependence in decision-making ability regarding tasks of daily life, depressed mood indicators, behavioral symptoms, history of falls, and bowel incontinence were positively associated with antipsychotic drug use. In addition to the use of antipsychotic agents in schizophrenia and bipolar mania, this study found high use in conditions such as dementia, anxiety, depression, and parkinsonism in the elderly. CONCLUSIONS: Nearly 1 in 4 elderly nursing home residents in the United States received antipsychotic agents. Predisposing and need factors played a vital role in determining the use of antipsychotic agents in these elderly patients. Overall, the study findings suggest that there is a need to monitor antipsychotic drug use by elderly patients in US nursing homes in light of recent efficacy and safety data on atypical agents. SN - 1543-5946 UR - https://www.unboundmedicine.com/medline/citation/19028374/Antipsychotic_drug_use_among_elderly_nursing_home_residents_in_the_United_States_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1543-5946(08)00054-8 DB - PRIME DP - Unbound Medicine ER -