Psychotropic drug use in residents with dementia living in small-scaled special care facilities; a longitudinal study

Abstract

Objectives: Over the past decade, a trend has been noticed in the Netherlands to replace large-scaled special care units (SCUs) caring for 20–30 residents with dementia by small-scaled SCUs caring for up to 8 residents. Systematic evaluations, however, have yielded a differentiated picture of the effects. As the impact on psychotropic drug use has hardly been addressed thus far, we examined the (potential) impact of psychotropic drug use when moving residents with dementia from large-scaled to small-scaled SCUs.

Methods: We conducted a non-randomized, controlled study with a six-month follow-up. Among 145 residents with dementia living a large-scaled SCUs for dementia caring for 20–30 residents per unit, a total of 77 residents were moved to small-scaled SCUs caring for up to 8 residents per unit. Psychotropic drug use, classified according to the Anatomical Therapeutic Chemical Classification (ATC) system was monitored at 2 months before replacement, as well as at 3 and 6 months thereafter. Repeated measures ANOVAs were conducted for the mean Defined Daily Doses (DDDs) of both groups.

Results: No significant differences between both groups in psychotropic medication use were found over a period of 8 months.

Conclusion: Prescription of psychotropic drugs does not change after a transfer from a large-scaled SCU to a small-scaled SCU of patients with moderate to severe dementia.

Current Controlled Trials: ISRCTN11151241.

Keywords:

• Dementia
• nursing home
• medication elderly
• psychotropic drugs

Acknowledgements

We are very thankful to the legal representatives of the residents of the SCUs for their consent for this study.

Conflict of interests

The authors report no conflict of interest.

Data

The authors are willing to allow the journal to review the data if requested.

Author contributions

Conceived and designed the experiments: JSK, EJAS. Performed the experiments: JSK. Analyzed the data: JSK. Wrote the paper: JSK, RCOV, EJAS. Conceived and designed the original study: JSK, EJAS.