Fourteen-Year Trends in the Use of Psychotropic Medications, Opioids, and Other Sedatives Among Institutionalized Older People in Helsinki, Finland

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Roitto , H-M , Kautiainen , H , Aalto , U L , Ohman , H , Laurila , J & Pitkala , K H 2019 , ' Fourteen-Year Trends in the Use of Psychotropic Medications, Opioids, and Other Sedatives Among Institutionalized Older People in Helsinki, Finland ' , Journal of the American Medical Directors Association , vol. 20 , no. 3 , pp. 305-311 . https://doi.org/10.1016/j.jamda.2018.12.022

Title: Fourteen-Year Trends in the Use of Psychotropic Medications, Opioids, and Other Sedatives Among Institutionalized Older People in Helsinki, Finland
Author: Roitto, Hanna-Maria; Kautiainen, Hannu; Aalto, Ulla L.; Ohman, Hannareeta; Laurila, Jouko; Pitkala, Kaisu H.
Contributor: University of Helsinki, Department of General Practice and Primary Health Care
University of Helsinki, Clinicum
University of Helsinki, Department of General Practice and Primary Health Care
University of Helsinki, Department of General Practice and Primary Health Care
University of Helsinki, Department of General Practice and Primary Health Care
University of Helsinki, Department of General Practice and Primary Health Care
Date: 2019-03
Language: eng
Number of pages: 7
Belongs to series: Journal of the American Medical Directors Association
ISSN: 1525-8610
URI: http://hdl.handle.net/10138/321650
Abstract: Objectives: The use of psychotropic drugs in long-term care (LTC) is very common, despite their known adverse effects. The prevalence of opioid use is growing among older adults. This study aimed to investigate trends in the prevalence of psychotropics, opioids, and sedative load in a LTC setting over a 14-year period. We also explored the interaction of psychotropic and opioid use according to residents' dementia status in nursing home (NH) and assisted living facility (ALF) settings. Design: Four cross-sectional studies. Setting: Institutional settings in Helsinki, Finland. Participants: Older residents in NHs in 2003 (n = 1987), 2011 (n = 1576), and 2017 (n = 791) and in ALFs in 2007 (n = 1377), 2011 (n = 1586), and 2017 (n = 1624). Measures: Comparable assessments were conducted among LTC residents at 4 time points over 14 years. The prevalence of regular psychotropics, opioids, and other sedatives and data on demographics and diagnoses were collected from medical records. Results: Disabilities and severity of dementia increased in both settings over time. The prevalence of all psychotropics decreased significantly in NHs (from 81% in 2003 to 61% in 2017), whereas in ALFs there was no similar linear trend (65% in 2007 and 64% in 2017). There was a significant increase in the prevalence of opioids in both settings (30% in NHs and 22% in AFLs in 2017). Residents with dementia used less psychotropics and opioids than those without dementia in both settings and at each time point. Conclusions/Implications: NHs show a favorable trend in psychotropic drug use, but the rates of psychotropic use remain high in both NHs and ALFs. In addition, the rates of opioid use have almost tripled, leading to a high sedative load among LTC residents. Clinicians should carefully consider the risk-to-benefit ratio when prescribing in LTC. (C) 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
Subject: Psychotropics
opioids
sedative load
long-term care
nursing home
TERM-CARE FACILITIES
NORWEGIAN NURSING-HOMES
DEMENTIA
RESIDENTS
SYMPTOMS
3121 General medicine, internal medicine and other clinical medicine
3142 Public health care science, environmental and occupational health
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