Health, functional, psychological and nutritional status of cognitively impaired long-term care residents in Poland

Kijowska, Violetta; Barańska, Ilona; Szczerbińska, Katarzyna

doi:10.1007/s41999-019-00270-5

Cited by 4 publications

(8 citation statements)

References 43 publications

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“…The assessments were done mainly on the basis of a 3-day observation of the residents, and supported (if necessary) by data obtained from medical files, family members or other staff. The study protocol and comprehensive characteristics of the study group has been described in detail elsewhere [6,12].…”

Section: Methodsmentioning

confidence: 99%

“…The study was performed in 2015-2016 within 23 LTC institutions in Poland, randomly selected in all 6 regions in terms of size, status, geographical region, number of beds and facility type: NH, which is similar to a skilled nursing facility, and RH-a residential facility referring to the classification proposed by experts' panel in JAMDA in 2015 [13]. A detailed description of inclusion criteria to the study [6] and a comparison of both types of the facilities have been published elsewhere [12]. The study received approval from the relevant University Ethics Committee (decision No.…”

Section: Settings and Participantsmentioning

confidence: 99%

“…In Poland, there are two types of LTC institutions (LTCIs): residential homes (RH) served by off-site general practitioners (GP) and nursing homes (NH) with physicians (with various specializations) employed for 24 h per 7 days a week. These facilities are organized and funded on a different basis (described elsewhere) [12], where prescribing and administering of medicines are organized differently (supplemental Table 1). Patients with CI may be equally referred to RHs and NHs, however, due to the diverse range of services provided in these facilities, treatment of CI may differ between them.…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with drug prescribing practices in long-term care patients with cognitive impairment

2020

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Purpose To examine factors associated with prescribing anti-dementia medicines (ADM), atypical antipsychotics (A-APM), typical antipsychotics (T-APM), anxiolytics and other psychostimulants (OP) in the residents of long-term care institutions (LTCIs). Methods A cross-sectional survey of a country-representative sample of randomly selected LTCIs in Poland, conducted in 2015–2016. First, we identified 1035 residents with cognitive impairment (CI) among all 1587 residents. Next, we randomly selected 20 residents from each institution. Study sample consists of 455 residents with CI: 214 recruited from 11 nursing homes and 241 from 12 residential homes. We used InterRAI-LTCF questionnaire and drug dispensary cards administered on the day of data collection to assess use of drugs. Multiple correspondence analysis (MCA), descriptive and logistic regression analyses were performed. Results The residents were treated with ADM (13.4%), OP (14.3%), antipsychotics (46.4%) including A-APM (24.2%) and T-APM (27.9%), and anxiolytics (28.4%). Hydroxyzine was used most often among anxiolytics (71.3%). Prescribing of ADM was more likely in Alzheimer’s disease (OR = 4.378; 95%CI 2.173–8.823), while OP in other dementia (OR = 1.873; 95%CI 1.007–3.485). Administration of A-APM was more likely in older residents (OR = 1.032, 95%CI 1.009–1.055), and when delusions appeared (OR = 2.082; 95%CI 1.199–3.613), while there were no neuropsychiatric factors increasing the odds of T-APM use. Prescribing of anxiolytics was less likely in moderate CI (by 47.2%) than in residents with mild CI. Conclusion Current practices of prescribing psychotropics are inadequate in Polish LTCIs, especially in terms of use of T-APM and hydroxyzine. More attention should be given to motivate physicians to change their prescribing practices.

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Section: Methodsmentioning

confidence: 99%

Section: Settings and Participantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors associated with drug prescribing practices in long-term care patients with cognitive impairment

2020

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“…This study also revealed a high prevalence of neuropsychiatric symptoms (NPS) among these residents. We found that prevalence of aggressive behavior (49.5%), agitation (30.3%), and wandering (22.7%) did not differ significantly between the different settings, but NH residents were more likely to show resistance to care (up to 38.7%), hallucinations (up to 25.5%) and delusions (up to 28.9%) when compared to RH residents [4].…”

Section: Introductionmentioning

confidence: 73%

“…Facilities were randomly selected in all six macro regions (according to the Nomenclature of Territorial Units for Statistics codes-Level NUTS 1, as binding in 2014) in terms of size, status, geographical region, number of beds and facility type. The study protocol, including a detailed sample calculation and inclusion criteria to the study [3], as well as comparison of organization of both types of the facilities [4], have been described in detail elsewhere.…”

Section: Recruitmentmentioning

confidence: 99%

Use of non-pharmacological interventions in patients with cognitive impairment: a comparison of residential and nursing homes in Poland

Kijowska¹,

Barańska²,

Stodolska³

et al. 2020

Polish Archives of Internal Medicine

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Relationship between administrative characteristics of long‐term care institutions and use of antipsychotics and anxiolytics in residents with cognitive impairment

Kijowska

Barańska

Szczerbińska

2020

Int J Geriat Psychiatry

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ObjectivesTo identify the facility characteristics that are associated with prescribing practices of typical and atypical antipsychotics, and anxiolytics in residents with cognitive impairment in long‐term care (LTC) institutions.MethodsA cross‐sectional analysis of a country‐representative sample of 23 LTC institutions in Poland was conducted in 2015–2016. Trained staff from each facility used the InterRAI‐LTCF tool and drug dispensary cards on the day of resident's assessment to collect data on medication use from 455 residents with cognitive impairment. We used the anatomical therapeutic chemical classification and a multiple correspondence analysis.ResultsWe identified facility characteristics associated with higher rate of prescribing of: typical antipsychotics (nursing home, private ownership status, higher staff/bed ratio of physicians and nurses, and lower as refers to care assistants); atypical antipsychotics (residential home, public ownership status, higher staff/bed ratio of care assistants, and lower as refers to physicians); and anxiolytics (residential home, facilities of small size, public ownership status, higher staff/bed ratio of care assistants, lower of nurses and physicians). In the facilities where less residents received typical antipsychotics, anxiolytics were prescribed more often, and vice versa (rho = −0.442; p = 0.035).ConclusionThis study showed a considerable variation in the use of typical and atypical antipsychotics, and anxiolytics between nursing and residential homes, which was associated with their organization (type, size, ownership status, and employment rate). We found a negative correlation between prescribing typical antipsychotics and anxiolytics, which made us aware that these medications may be used interchangeably in LTC facilities, despite the fact that both should be avoided.

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Health, functional, psychological and nutritional status of cognitively impaired long-term care residents in Poland

Cited by 4 publications

References 43 publications

Factors associated with drug prescribing practices in long-term care patients with cognitive impairment

Factors associated with drug prescribing practices in long-term care patients with cognitive impairment

Use of non-pharmacological interventions in patients with cognitive impairment: a comparison of residential and nursing homes in Poland

Relationship between administrative characteristics of long‐term care institutions and use of antipsychotics and anxiolytics in residents with cognitive impairment

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