Psychotropic drug use in a group of Dutch nursing home patients with dementia: many users, long-term use, but low doses

Abstract

The aim of this study was to describe the use of psychotropic drugs in a psychogeriatric nursing home, "Joachim en Anna", in Nijmegen, the Netherlands. To this end the medical records of 890 nursing home patients with dementia, admitted between 1980 and 1989, were analysed retrospectively. Each time pattern of psychotropic drug use was registered. Drugs were coded by means of the Anatomical Therapeutic Chemical classification system. The daily dose was expressed as the ratio of the mean prescribed daily dose and the defined daily dose. Side-effects and changes in prescription patterns throughout the years patients were admitted were analysed. A total of 3,090 time patterns of exposure to psychotropics were registered. Neuroleptics, benzodiazepines, and antidepressants accounted for 58, 32, and 9 percent of the time patterns, respectively. For almost every drug prescription the prescribed daily dose was lower than the defined daily dose. More than 75 percent of these nursing home patients had at least one prescription for a psychotropic drug during institutionalization. One or more side-effects were observed in 50 percent of the patients who used a neuroleptic. The total number of patients receiving psychotropics did not change throughout the study. Psychotropics were prescribed for long-term use, but in a low dose. Side-effects were frequently observed while the correct individual dose was being determined.