The dispensing of psychotropic medicines to older people before and after they enter residential aged care

Harrison, Stephanie L ORCID: 0000-0002-8846-0946, Sluggett, Janet K, Lang, Catherine, Whitehead, Craig, Crotty, Maria, Corlis, Megan, Wesselingh, Steven L and Inacio, Maria C
(2020) The dispensing of psychotropic medicines to older people before and after they enter residential aged care. MEDICAL JOURNAL OF AUSTRALIA, 212 (7). pp. 309-313.

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<h4>Objective</h4>To examine the prevalence of psychotropic medicine dispensing before and after older people enter residential care.<h4>Design</h4>Retrospective national cohort study; analysis of Registry of Senior Australians (ROSA) data.<h4>Setting, participants</h4>All concession card-holding residents of government-subsidised residential aged care facilities in Australia who entered residential care for at least three months between 1 April 2008 and 30 June 2015.<h4>Main outcome measures</h4>Proportions of residents dispensed antipsychotic, benzodiazepine, or antidepressant medicines during the year preceding and the year after commencing residential care, by quarter.<h4>Results</h4>Of 322 120 included aged care residents, 68 483 received at least one antipsychotic (21.3%; 95% CI, 21.1-21.4%), 98 315 at least one benzodiazepine (30.5%; 95% CI, 30.4-30.7%), and 122 224 residents at least one antidepressant (37.9%; 95% CI, 37.8-38.1%) during their first three months of residential care; 31 326 of those dispensed antipsychotics (45.7%), 38 529 of those dispensed benzodiazepines (39.2%), and 25 259 residents dispensed antidepressants (19.8%) had not received them in the year preceding their entry into care. During the first three months of residential care, the prevalence of antipsychotic (prevalence ratio [PR], 3.37; 95% CI, 3.31-3.43) and antidepressant dispensing (PR, 1.05; 95% CI, 1.04-1.07) were each higher for residents with than for those without dementia; benzodiazepine dispensing was similar for both groups (PR, 1.01; 95% CI, 0.99-1.02).<h4>Conclusions</h4>Dispensing of psychotropic medicines to older Australians is high before they enter residential care but increases markedly soon after entry into care. Non-pharmacological behavioural management strategies are important for limiting the prescribing of psychotropic medicines for older people in the community or in residential care.

Item Type: Article
Uncontrolled Keywords: Dementia, Antipsychotic agents, Antidepressive agents
Depositing User: Symplectic Admin
Date Deposited: 06 Jul 2020 15:32
Last Modified: 01 Feb 2024 19:59
DOI: 10.5694/mja2.50501
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