Abstract
The Nursing Home Reform Act (NHRA) sought to liberate residents from overuse of chemical restraints. The primary purpose of this study was to determine if the gender of residents in one nursing home was predictive of psychotropic drug prescribing over a six-year period as it corresponded to NHRA implementation. ANOVA and logistic regression analyses were utilized to identify trends in prescribing and predictor variables for psychotropic drug prescribing. While initial assessment of data from this nursing home appeared to support the conclusion that the aim of the NHRA had been achieved, closer assessment suggested that male residents were being medicated more than their female counterparts with similar physical, emotional, and cognitive concerns. Possible explanations for the results are discussed and include poorer health status of male residents, different mechanisms male residents use to cope with loss, and male residents' more problematic behavioral symptoms associated with dementia.
After widespread misuse of psychotropic drugs in nursing homes came to light, the NHRA was implemented in 1991 in an effort to combat the excessive and unwarranted use of chemical and physical restraints. The NHRA was a component of the 1987 Omnibus Budget Reconciliation Act.1 While reports indicating that psychotropic drug prescribing have decreased since 1990 are encouraging, 28 a more detailed analysis is warranted to determine if this decrease is similar for male and female residents. This research focuses on gender differences in psychotropic drug prescribing in one nursing home and seeks to explain such use at three points in time that correspond to well before, immediately before, and well after implementation of the NHRA.
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