Factors influencing psychotropic prescription by non-psychiatrist physicians in a nursing home for the elderly in Brazil

Abstract

CONTEXT AND OBJECTIVE: Although psychotropics are one of the classes of medications most prescribed in nursing homes for the elderly, studies examining prescribing patterns are limited in both number and scope. The present study was undertaken to investigate factors associated with general psychotropic use in a nursing home in Brazil. DESIGN AND SETTING: Retrospective observational study at the Nursing Home for the Elderly, Institute of Biosciences, Universidade Estadual Paulista. METHODS: Information on prescriptions was retrieved from the medical records of 108 elderly residents in a nursing home. Sixty-five of these patients, with mean age 74.5 years (± standard deviation 9.4 years), who were taking medications on a regular basis, comprised the sample. The effects of demographic and clinical variables on the psychotropic prescription pattern were examined. RESULTS: Females were more likely to receive psychotropics (p = 0.038). Individuals on medicines for cardiovascular diseases received psychotropics less frequently (p = 0.001). The number of prescribed psychotropics correlated negatively with both age (p = 0.009) and number of non-psychotropic drugs (p = 0.009). CONCLUSIONS: Although preliminary, the present results indicated that cardiovascular disease was the clinical variable that most influenced psychotropic prescription. Physicians' overconcern regarding drug interactions might at least partially explain this result. Further investigations involving larger sample sizes from different regions are warranted to confirm these findings.

Depression and Cognitive Decline: Factors Related to Demographics and Psycho Pharmacotherapy on Elderly in Nursing Homes

“…Such results are alarming, considering that the consume of five or more medicine per day and the realization of pharmacological treatment for three or more different health problems are considered to be risk factors for the emergence of problems related to medicines (PRMs) [23]. Other researches also have observed an increase in consumption of neuropsychiatric medicines on the elderly, estimating that the prevalence of these medicines among elders admitted in nursing homes reaches up to 63,0% [63].…”

Fatores associados ao uso de psicofármacos em idosos asilados

“…Não se encontrou associação entre medicamentos psicoativos e faixa etária no presente estudo, achado concordante com alguns estudos 29,30 porém divergente de outros 2,15 . O fato de a presente casuística ser composta apenas de idosos pode ser uma das justifi cativas para esse achado.…”

“…Crê-se que a razão para isso foi que a presente casuística é composta de pacientes com síndromes demenciais e doenças cerebrovasculares, enquanto que Stella et al 2 avaliaram internados com preponderância de doenças cardiovasculares. Relações de sexo e idade não foram evidenciadas em estudos de casuísticas originárias de ILPI 31 , sugerindo que essas relações se tornam mais evidentes fora do contexto de asilados em geral.…”

“…Na literatura brasileira consultada, encontrou-se um único estudo que abordou essa temática em ILPI, realizado em Rio Claro (SP) 2 .…”

Medicamentos e sondas de nutrição

“…Searching the keywords: drug, therapy, feeding tubes, nursing homes in the website http://www.nlm.nih.gov on June 30 2008, we found a total of 18 articles that mostly focused on discussing hydration, Rev Assoc Med Bras 2010; 56(1): [17][18][19][20][21] nutrition, bronchoscopic aspiration, demential and terminal states. Only two of these studies analyzed drugs and feeding tubes in LTCFs, but both of them considered costs and did not study the pharmacological aspects.12,13 The same keywords were searched for in the website http://www.scielo.br and we could not find any study about this topic.…”