The Prevalence of and Documented Indications for Antipsychotic Prescribing in Irish Nursing Homes.

BACKGROUND

Antipsychotic medications are often used 'off-licence' to treat neuropsychiatric symptoms and disorders of aging and to manage behavioural and psychological symptoms of dementia despite the warnings of adverse effects.

OBJECTIVE

To establish the prevalence of and documented indication for antipsychotic medication use in the Irish nursing home setting.

SETTING

This study was conducted in six nursing homes located in Co. Cork, Ireland.

METHOD

A retrospective, cross-sectional study was employed. All patients who met the inclusion criteria (≥65 years, residing in a nursing home on a long-term basis) were eligible for inclusion. There were 120 nursing home residents recruited to the study.

MAIN OUTCOME MEASURE

The prevalence of antipsychotic medication use in nursing home residents (with and without dementia).

RESULTS

The overall prevalence of antipsychotic prescribing was found to be 48% and patients with dementia were significantly more likely to be prescribed an antipsychotic compared to those without dementia (67% vs. 25%) (χ (1, = 120) = 21.541, < 0.001). In the cohort of patients with dementia, there was a trend approaching significance ( = 0.052) of decreasing antipsychotic use with increasing age (age 65-74 = 90%; age 75-84 = 71%; age 85 and over = 58%). An indication was documented for 84% of the antipsychotic prescriptions in this cohort.

CONCLUSIONS

The findings of this study highlight that high rates of antipsychotic medication use remains an issue in Irish nursing homes. Further work should explore factors in influencing prescribing of these medications in such settings.