INSERM, Toulouse, France.
J Am Med Dir Assoc. 2012 May;13(4):407.e7-12. doi: 10.1016/j.jamda.2011.12.056. Epub 2012 Jan 20.
To quantify transitions of residents into or out of nursing homes (NHs) and to describe psychotropic drug prescription at admission and discharge and with regard to dementia diagnosis.
A descriptive, cross-sectional, noninterventional study.
The setting included 300 NH in France.
Participants included 2231 NH residents.
Participants reported the number, origin, and destination of residents transiting into or out of the NH in the previous 3 months and provided information on NH characteristics. For eight residents admitted or discharged by the NH, information was collected on medical characteristics, including psychotropic and antidementia drug prescription, and dementia status.
The mean number of beds in participating NHs was 85.9 ± 33.2 (mean occupation rate = 96.6%). The mean number of admissions and discharges in the previous 3 months was 13.7 ± 8.5 and 11.2 ± 4.3, respectively. Most admissions (direct admission 3.2 ± 3.3 or readmission 6.4 ± 6.0) and discharges (4.4 ± 6.7) were from and to the hospital. Of the 2231 residents included, 1005 (45.0%) were diagnosed with dementia. At least one psychotropic drug (antidepressant, hypnotic, antipsychotic, or anxiolytic) was prescribed to 70.7% of residents and in particular an antipsychotic to 19.1% of residents. Psychotropic drugs, and in particular antipsychotic drugs, were significantly more prescribed to demented residents than to nondemented residents (76.2% vs 64.3% and 28.0% vs 11.8%, respectively). The extent of prescription (at least one psychotropic drug) was similar in residents admitted to (70.2%) and discharged from (67.5%) the NHs. Antidementia drugs (acetylcholinesterase inhibitors or NMDA receptor antagonists) were prescribed to 53.7% of demented residents.
Movement of residents into and out of NHs and especially from and to the hospital is extensive and the prescription rate for psychotropic drugs is very high in this population, especially in residents with dementia. Multiple groups of health care providers should be targeted by educational measures to improve the quality of care for NH residents.
量化居民入住或离开养老院（NH）的情况，并描述入住时和出院时以及根据痴呆诊断开具的精神药物处方情况。
描述性、横断面、非干预性研究。
研究地点包括法国的 300 家 NH。
2231 名 NH 居民参与了该项研究。
参与者报告了前 3 个月内入住或离开 NH 的居民人数、来源和去向，并提供了 NH 特征的信息。对于由 NH 收治或出院的 8 名居民，收集了包括精神药物和抗痴呆药物处方以及痴呆状态在内的医疗特征信息。
参与 NH 的平均床位数为 85.9 ± 33.2（平均入住率=96.6%）。前 3 个月的平均入院和出院人数分别为 13.7 ± 8.5 和 11.2 ± 4.3。大多数入院（直接入院 3.2 ± 3.3 或再入院 6.4 ± 6.0）和出院（4.4 ± 6.7）来自或去往医院。在 2231 名居民中，1005 名（45.0%）被诊断为痴呆。至少开具了一种精神药物（抗抑郁药、催眠药、抗精神病药或抗焦虑药）的居民比例为 70.7%，特别是抗精神病药的比例为 19.1%。与非痴呆居民相比，痴呆居民开具精神药物（特别是抗精神病药物）的比例显著更高（分别为 76.2%比 64.3%和 28.0%比 11.8%）。入住（70.2%）和出院（67.5%） NH 的居民中，处方的程度（至少开具一种精神药物）相似。乙酰胆碱酯酶抑制剂或 NMDA 受体拮抗剂）处方给 53.7%的痴呆居民。
居民入住和离开 NH，特别是从医院转入和转出 NH 的情况非常普遍，该人群中精神药物的处方率非常高，尤其是痴呆患者。应针对多个医疗保健提供者群体采取教育措施，以提高 NH 居民的护理质量。
