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Trends in psychotropic drug prescribing in Norwegian nursing homes from 1997 to 2009: a comparison of six cohorts

Authors

  • Sabine Ruths,

    Corresponding author
    1. Research Unit for General Practice, Uni Health/Uni Research, Bergen, Norway
    • Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
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  • Pernille Hegre Sørensen,

    1. Division of Psychiatry, Stavanger Hospital Trust, Stavanger, Norway
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  • Øyvind Kirkevold,

    1. Norwegian Centre for Dementia Research, Vestfold Hospital Trust, Tønsberg, Norway
    2. Research Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
    3. Faculty of Health and Sport, University of Agder, Kristiansand, Norway
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  • Bettina S. Husebø,

    1. Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
    2. Regional Centre of Elderly Medicine and Coordination, Stavanger University Hospital, Norway
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  • Kjell Krüger,

    1. Løvåsen Teaching Nursing Home, Municipality of Bergen, Norway
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  • Kjell H Halvorsen,

    1. Regional Medicines Information and Pharmacovigilance Centre, University Hospital of North Norway, Tromsø, Norway
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  • Geir Selbæk

    1. Research Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
    2. Akershus University Hospital, Oslo, Norway
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Correspondence to: Dr S. Ruths, E-mail: sabine.ruths@isf.uib.no

Abstract

Background

Psychotropic drugs are extensively prescribed for the treatment of neuropsychiatric symptoms, despite modest efficacy and severe side effects.

Aims

We examined trends in psychotropic drug prescribing in Norwegian nursing homes from 1997 to 2009, in order to gain insight in practice development.

Methods

The study is a secondary data analysis of six cross-sectional nursing home studies conducted between 1997 and 2009. Patients aged >65 years were included. We compared the prevalence of psychotropic drugs (antipsychotics, anxiolytics, hypnotics, and antidepressants). Associations between prescription of psychotropics, and patients' age, gender, type of ward, and year of data collection were examined by univariate analysis and logistic regression.

Results

Altogether, 7 661 patients (mean age 85.2 years, 72.6% women) were included. Prevalence of all psychotropic drugs combined increased from 57.6% to 70.5%, anxiolytics from 14.9% to 21.9%, hypnotics from 14.5% to 22.9%, and antidepressants from 31.5% to 50.9%. Prevalence of antipsychotics varied between extremes 21.1% and 25.6%. Less prescribing of older drugs was exceeded by an increase in newer drug types. Concomitant prescribing of two or more psychotropic drugs increased from 21% to 33%. Predictors of psychotropic drugs were female gender (except antipsychotics), as well as age <80 years, and residency in special care units (except hypnotics).

Conclusions

Prescribing of psychotropic drugs in nursing homes has increased considerably, especially regarding antidepressants. Explanations for this trend need to be further explored. Copyright © 2012 John Wiley & Sons, Ltd.

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