Associated Factors With Antipsychotic Use in Long-Term Institutional Care in Eight European Countries: Results From the RightTimePlaceCare Study

作者：de Mauleon Adelaide; Sourdet Sandrine; Renom Guiteras Anna; Gillette Guyonnet Sophie; Leino Kilpi Helena; Karlsson Staffan; Bleijlevens Michel; Zabategui Adela; Saks Kai; Vellas Bruno; Jolley David; Soto Maria^*

来源：Journal of the American Medical Directors Association, 2014, 15(11): 812-818.

DOI：10.1016/j.jamda.2014.06.015

• Dementia
• elderly
• antipsychotic
• nursing home

Objectives: To determine factors associated with the antipsychotic (AP) prescription for people with dementia (PwD) recently admitted to institutional long-term care facilities (LTCFs) and to ascertain differences in the use of this medication in 8 European countries. %26lt;br%26gt;Design: An exploratory cross-sectional study. Setting: LTCFs from 8 European countries (Estonia, Finland, France, Germany, The Netherlands, Spain, Sweden, and England). %26lt;br%26gt;Participants: A total of 791 PwD recently admitted to an LTCF and their caregivers. %26lt;br%26gt;Measurements: Baseline data from RightTimePlaceCare survey was used. Patients%26apos; medical conditions, neuropsychiatric symptoms, physical and cognitive status, and medications were recorded. Multiple logistic regression models were used to assess associations with the AP use. %26lt;br%26gt;Results: A group of 296 patients (37.4%) of 791 patients recently admitted received AP medication. The prevalence of the use of 1 or more APs varied between study countries, ranging from 12% in Sweden to 54% in Spain. Factors independently associated with the AP use were living in Sweden [odds ratio (OR) 0.12, 95% confidence interval (CI) 0.05-0.30], Finland (OR 0.26, 95% CI 0.14-0.48), Germany (OR 2.75, 95% CI 1.55-4.86) and Estonia (OR 6.79, 95% CI 3.84-12.0). The odds of AP use decreased with the presence of a dementia specific unit in the LTCF (OR 0.60, 95% CI 0.39-0.92), but was higher among residents with a hyperactivity behavior (OR 2.12, 95% CI 1.41-3.18). %26lt;br%26gt;Conclusion: The current study shows that more than one-third of the residents recently admitted received APs and that prescription frequency across countries varied significantly. This study raises the possibility that the presence of a dementia-specific unit might play a role in the AP use. Further studies should investigate this association and seek better understanding of what will achieve optimal quality of AP use among newly admitted residents in LTCF.

• 出版日期2014-11