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BMC Geriatrics

, 11:56

First Online: 30 September 2011Received: 01 July 2011Accepted: 30 September 2011


BackgroundThe objective of this study was to determine the sedative load and use of sedative and psychotropic medications among older people with dementia living in residential care homes.

MethodsMedication data were collected at baseline and at two further time-points for eligible residents of six care homes participating in the EVIDEM-End Of Life EOL study for whom medication administration records were available. Regular medications were classified using the Anatomical Therapeutic Chemical classification system and individual sedative loads were calculated using a previously published model.

ResultsAt baseline, medication administration records were reviewed for 115 residents; medication records were reviewed for 112 and 105 residents at time-points 2 and 3 respectively. Approximately one-third of residents were not taking any medications with sedative properties at each time-point, while a significant proportion of residents had a low sedative load score of 1 or 2 54.8%, 59.0% and 57.1% at baseline and time-points 2 and 3 respectively. More than 10% of residents had a high sedative load score ≥ 3 at baseline 12.2%, and this increased to 14.3% at time-points 2 and 3. Approximately two-thirds of residents 66.9% regularly used one or more psychotropic medications. Antidepressants, predominantly selective serotonin re-uptake inhibitors SSRIs, were most frequently used, while antipsychotics, hypnotics and anxiolytics were less routinely administered. The prevalence of antipsychotic use among residents was 19.0%, lower than has been previously reported for nursing home residents. Throughout the duration of the study, administration of medications recognised as having prominent sedative adverse effects and-or containing sedative components outweighed the regular use of primary sedatives.

ConclusionsSedative load scores were similar throughout the study period for residents with dementia in each of the care homes. Scores were lower than previously reported in studies conducted in long-term care wards which have on-site clinical support. Nevertheless, strategies to optimise drug therapy for care home residents with dementia which rely on clinicians external to the care home for support and medication review are required.

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Autor: Carole Parsons - Jane Haydock - Elspeth Mathie - Natasha Baron - Ina Machen - Elizabeth Stevenson - Sarah Amador - Claire 


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