Associated Factors With Antipsychotic Use in Long-Term Institutional Care in Eight European Countries: Results From the RightTimePlaceCare Study

A. de Mauleon, S. Sourdet, A. Renom-Guiteras, S. Gillette-Guyonnet, H. Leino-Kilpi, S. Karlsson, M. Bleijlevens, A. Zabalegui, K. Saks, B. Vellas, D. Jolley, M. Soto, the RightTimePlaceCare Consortium

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Abstract

Objectives: To determine factors associated with the antipsychotic (AP) prescription for people with dementia (PwD) recently admitted to institutional long-term care facilities (LTCFs) and to ascertain differences in the use of this medication in 8 European countries.

Design: An exploratory cross-sectional study. Setting: LTCFs from 8 European countries (Estonia, Finland, France, Germany, The Netherlands, Spain, Sweden, and England).

Participants: A total of 791 PwD recently admitted to an LTCF and their caregivers.

Measurements: Baseline data from RightTimePlaceCare survey was used. Patients' medical conditions, neuropsychiatric symptoms, physical and cognitive status, and medications were recorded. Multiple logistic regression models were used to assess associations with the AP use.

Results: A group of 296 patients (37.4%) of 791 patients recently admitted received AP medication. The prevalence of the use of 1 or more APs varied between study countries, ranging from 12% in Sweden to 54% in Spain. Factors independently associated with the AP use were living in Sweden [odds ratio (OR) 0.12, 95% confidence interval (CI) 0.05-0.30], Finland (OR 0.26, 95% CI 0.14-0.48), Germany (OR 2.75, 95% CI 1.55-4.86) and Estonia (OR 6.79, 95% CI 3.84-12.0). The odds of AP use decreased with the presence of a dementia specific unit in the LTCF (OR 0.60, 95% CI 0.39-0.92), but was higher among residents with a hyperactivity behavior (OR 2.12, 95% CI 1.41-3.18).

Conclusion: The current study shows that more than one-third of the residents recently admitted received APs and that prescription frequency across countries varied significantly. This study raises the possibility that the presence of a dementia-specific unit might play a role in the AP use. Further studies should investigate this association and seek better understanding of what will achieve optimal quality of AP use among newly admitted residents in LTCF. (C) 2014 AMDA e The Society for Post-Acute and Long-Term Care Medicine.

Original languageEnglish
Pages (from-to)812-818
Number of pages7
JournalJournal of the American Medical Directors Association
Volume15
Issue number11
DOIs
Publication statusPublished - Nov 2014

Keywords

  • Dementia
  • elderly
  • antipsychotic
  • nursing home
  • NURSING-HOME RESIDENTS
  • ALZHEIMERS-DISEASE
  • ATYPICAL ANTIPSYCHOTICS
  • DEMENTIA
  • METAANALYSIS
  • AGITATION
  • DRUGS
  • MEDICATIONS
  • PREVALENCE
  • VALIDATION

Cite this

de Mauleon, A., Sourdet, S., Renom-Guiteras, A., Gillette-Guyonnet, S., Leino-Kilpi, H., Karlsson, S., Bleijlevens, M., Zabalegui, A., Saks, K., Vellas, B., Jolley, D., Soto, M., & RightTimePlaceCare Consortium, T. (2014). Associated Factors With Antipsychotic Use in Long-Term Institutional Care in Eight European Countries: Results From the RightTimePlaceCare Study. Journal of the American Medical Directors Association, 15(11), 812-818. https://doi.org/10.1016/j.jamda.2014.06.015