Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Apr;212(7):309-313.
doi: 10.5694/mja2.50501. Epub 2020 Feb 11.

The dispensing of psychotropic medicines to older people before and after they enter residential aged care

Stephanie L Harrison  1   2 , Janet K Sluggett  1   3 , Catherine Lang  1 , Craig Whitehead  4 , Maria Crotty  5 , Megan Corlis  6 , Steven L Wesselingh  7 , Maria C Inacio  1   8
Affiliations

The dispensing of psychotropic medicines to older people before and after they enter residential aged care

Stephanie L Harrison et al. Med J Aust. 2020 Apr.

Abstract

Objective: To examine the prevalence of psychotropic medicine dispensing before and after older people enter residential care.

Design: Retrospective national cohort study; analysis of Registry of Senior Australians (ROSA) data.

Setting, participants: All concession card-holding residents of government-subsidised residential aged care facilities in Australia who entered residential care for at least three months between 1 April 2008 and 30 June 2015.

Main outcome measures: Proportions of residents dispensed antipsychotic, benzodiazepine, or antidepressant medicines during the year preceding and the year after commencing residential care, by quarter.

Results: Of 322 120 included aged care residents, 68 483 received at least one antipsychotic (21.3%; 95% CI, 21.1-21.4%), 98 315 at least one benzodiazepine (30.5%; 95% CI, 30.4-30.7%), and 122 224 residents at least one antidepressant (37.9%; 95% CI, 37.8-38.1%) during their first three months of residential care; 31 326 of those dispensed antipsychotics (45.7%), 38 529 of those dispensed benzodiazepines (39.2%), and 25 259 residents dispensed antidepressants (19.8%) had not received them in the year preceding their entry into care. During the first three months of residential care, the prevalence of antipsychotic (prevalence ratio [PR], 3.37; 95% CI, 3.31-3.43) and antidepressant dispensing (PR, 1.05; 95% CI, 1.04-1.07) were each higher for residents with than for those without dementia; benzodiazepine dispensing was similar for both groups (PR, 1.01; 95% CI, 0.99-1.02).

Conclusions: Dispensing of psychotropic medicines to older Australians is high before they enter residential care but increases markedly soon after entry into care. Non-pharmacological behavioural management strategies are important for limiting the prescribing of psychotropic medicines for older people in the community or in residential care.

Keywords: Antidepressive agents; Antipsychotic agents; Dementia.

PubMed Disclaimer

Comment in

References

    1. Westbury JL, Gee P, Ling T, et al. RedUSe: reducing antipsychotic and benzodiazepine prescribing in residential aged care facilities. Med J Aust 2018; 208: 398-403. https://www.mja.com.au/journal/2018/208/9/reduse-reducing-antipsychotic-...
    1. Westbury J, Gee P, Ling T, et al. More action needed: psychotropic prescribing in Australian residential aged care. Aust N Z J Psychiatry 2018; 53: 136-147.
    1. Royal Commission into Aged Care Quality and Safety. Restrictive practices in residential aged care in Australia (Background paper 4). May 2019. https://agedcare.royalcommission.gov.au/publications/Documents/backgroun... (viewed Aug 2019).
    1. Bradshaw SA, Playford ED, Riazi A. Living well in care homes: a systematic review of qualitative studies. Age Ageing 2012; 41: 429-440.
    1. NHS England. Optimising treatment and care for people with behavioural and psychological symptoms of dementia: a best practice guide for health and social care professionals. 2017. http://medicine.exeter.ac.uk/media/universityofexeter/medicalschool/pdfs... (viewed Aug 2019).