Antidepressants in nursing homes for dependent older patients: the cross-sectional associations of institutional factors with prescription conformance
Key summary points Aim To determine the proportion of non-conforming antidepressant prescriptions among nursing home residents and identify the associated institutional and demographic factors. Findings Despite the practice guidelines, non-conforming antidepressant prescribing is still of significan...
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| Veröffentlicht in: | European geriatric medicine 2019-06, Vol.10 (3), p.421-430 |
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| creator | Abdeljalil, Anne-Bahia Arbus, Christophe Montastruc, François de Souto Barreto, Philipe André, Laurine Vellas, Bruno Rolland, Yves |
| description | Key summary points
Aim
To determine the proportion of non-conforming antidepressant prescriptions among nursing home residents and identify the associated institutional and demographic factors.
Findings
Despite the practice guidelines, non-conforming antidepressant prescribing is still of significant concern in nursing homes, in over one-third of the residents. Institutional factors, such as simple drug prescribing actions and accessible psychiatric care, are associated with better antidepressant conformance and should be taken into account in further research.
Message
A “quality process” by the nursing home might optimize antidepressant prescribing for residents.
Purpose
Depression is diagnosed in approximately 40% of the nursing home (NH) residents, but the pertinence of the high use of antidepressants is often criticized. We aimed at determining the proportion of non-conforming antidepressant prescriptions among NH residents and the associated institutional and demographic factors.
Methods
Cross-sectional study of 2651 residents in 175 French NH participating in the IQUARE study (Impact of a QUAlity process on the development of practices and the functional decline of NH REsidents) and treated with antidepressants. Diagnosis of depression was obtained from the medical records. Antidepressant treatments were identified on the prescriptions and their conformance was analyzed in light of the international practice guidelines (i.e., indication, drug class, duplication, and monitoring).
Results
A total of 1017 residents (38.4%) had a non-conforming prescription. Availability of a list of recommended medications for older patients (OR = 1.39, 95% CI [1.15; 1.68],
p
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| doi_str_mv | 10.1007/s41999-019-00189-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2582806590</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2582806590</sourcerecordid><originalsourceid>FETCH-LOGICAL-c324t-40114620d6d53f14aa8df00d34bd6608cf9a1fe18e730bec3f581c763c03555d3</originalsourceid><addsrcrecordid>eNp9UUtLBDEMHkRB0f0Dnnr0MtpO59HxJosvELzouXTbdLfLbDs2HdQ_4u-1-zh4MhCSkO9LSL6iuGT0mlHa3WDN-r4vKctOmejLr6PijIlOlF3bdMd_8tNihrim2XjV9119Vvzc-eQMjBEQlU9InCd-iuj8kqzCBpDYEEkGgDfgEwmDgUhGlVyu8JakFRAdA2KJoJMLXg1EIQbt1LZCEmweicml6dC1SqcQkXy6tCLbvTq6cdsjOvi8bKO8hovixKoBYXaI58X7w_3b_Kl8eX18nt-9lJpXdSpryljdVtS0puGW1UoJYyk1vF6YtqVC214xC0xAx-kCNLeNYLpruaa8aRrDz4ur_dwxho8JMMmNQw3DoDyECWXViErQtulphlZ76O7cCFaO0W1U_JaMyq0Ocq-DzDrInQ7yK5P4noQZ7JcQ5TpMMb8B_2P9AlgakNw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2582806590</pqid></control><display><type>article</type><title>Antidepressants in nursing homes for dependent older patients: the cross-sectional associations of institutional factors with prescription conformance</title><source>SpringerLink Journals</source><creator>Abdeljalil, Anne-Bahia ; Arbus, Christophe ; Montastruc, François ; de Souto Barreto, Philipe ; André, Laurine ; Vellas, Bruno ; Rolland, Yves</creator><creatorcontrib>Abdeljalil, Anne-Bahia ; Arbus, Christophe ; Montastruc, François ; de Souto Barreto, Philipe ; André, Laurine ; Vellas, Bruno ; Rolland, Yves</creatorcontrib><description><![CDATA[Key summary points
Aim
To determine the proportion of non-conforming antidepressant prescriptions among nursing home residents and identify the associated institutional and demographic factors.
Findings
Despite the practice guidelines, non-conforming antidepressant prescribing is still of significant concern in nursing homes, in over one-third of the residents. Institutional factors, such as simple drug prescribing actions and accessible psychiatric care, are associated with better antidepressant conformance and should be taken into account in further research.
Message
A “quality process” by the nursing home might optimize antidepressant prescribing for residents.
Purpose
Depression is diagnosed in approximately 40% of the nursing home (NH) residents, but the pertinence of the high use of antidepressants is often criticized. We aimed at determining the proportion of non-conforming antidepressant prescriptions among NH residents and the associated institutional and demographic factors.
Methods
Cross-sectional study of 2651 residents in 175 French NH participating in the IQUARE study (Impact of a QUAlity process on the development of practices and the functional decline of NH REsidents) and treated with antidepressants. Diagnosis of depression was obtained from the medical records. Antidepressant treatments were identified on the prescriptions and their conformance was analyzed in light of the international practice guidelines (i.e., indication, drug class, duplication, and monitoring).
Results
A total of 1017 residents (38.4%) had a non-conforming prescription. Availability of a list of recommended medications for older patients (OR = 1.39, 95% CI [1.15; 1.68],
p
< 0.001) and regular intervention by a psychiatrist/psychiatric nurse in the facility (OR = 1.50, 95% CI [1.26; 1.77],
p
< 0.001) were associated with better antidepressant conformance. Women (OR = 0.76, 95% CI [0.61; 0.93],
p
< 0.05) and residents on multiple drugs (OR = 0.64, 95% CI [0.50; 0.80],
p
< 0.001) were at higher risk for non-conforming antidepressant prescription. A history of dementia (OR = 1.54, 95% CI [1.29; 1.84],
p
< 0.001), co-prescription of neuroleptics (OR = 4.23, 95% CI [2.20; 8.12],
p
< 0.001), and a known date of psychotropic initiation (OR = 2.58, 95% CI [2.10; 3.16],
p
< 0.001) were associated with better antidepressant conformance.
Conclusions
Our results suggest that a “quality process” by the NH combining accessible psychiatric care in facilities, pharmacological monitoring, and prescription improvement actions might optimize antidepressant prescribing for residents.]]></description><identifier>ISSN: 1878-7657</identifier><identifier>ISSN: 1878-7649</identifier><identifier>EISSN: 1878-7657</identifier><identifier>DOI: 10.1007/s41999-019-00189-x</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Geriatrics/Gerontology ; Internal Medicine ; Medicine ; Medicine & Public Health ; Research Paper</subject><ispartof>European geriatric medicine, 2019-06, Vol.10 (3), p.421-430</ispartof><rights>European Geriatric Medicine Society 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c324t-40114620d6d53f14aa8df00d34bd6608cf9a1fe18e730bec3f581c763c03555d3</citedby><cites>FETCH-LOGICAL-c324t-40114620d6d53f14aa8df00d34bd6608cf9a1fe18e730bec3f581c763c03555d3</cites><orcidid>0000-0002-5965-387X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s41999-019-00189-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s41999-019-00189-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids></links><search><creatorcontrib>Abdeljalil, Anne-Bahia</creatorcontrib><creatorcontrib>Arbus, Christophe</creatorcontrib><creatorcontrib>Montastruc, François</creatorcontrib><creatorcontrib>de Souto Barreto, Philipe</creatorcontrib><creatorcontrib>André, Laurine</creatorcontrib><creatorcontrib>Vellas, Bruno</creatorcontrib><creatorcontrib>Rolland, Yves</creatorcontrib><title>Antidepressants in nursing homes for dependent older patients: the cross-sectional associations of institutional factors with prescription conformance</title><title>European geriatric medicine</title><addtitle>Eur Geriatr Med</addtitle><description><![CDATA[Key summary points
Aim
To determine the proportion of non-conforming antidepressant prescriptions among nursing home residents and identify the associated institutional and demographic factors.
Findings
Despite the practice guidelines, non-conforming antidepressant prescribing is still of significant concern in nursing homes, in over one-third of the residents. Institutional factors, such as simple drug prescribing actions and accessible psychiatric care, are associated with better antidepressant conformance and should be taken into account in further research.
Message
A “quality process” by the nursing home might optimize antidepressant prescribing for residents.
Purpose
Depression is diagnosed in approximately 40% of the nursing home (NH) residents, but the pertinence of the high use of antidepressants is often criticized. We aimed at determining the proportion of non-conforming antidepressant prescriptions among NH residents and the associated institutional and demographic factors.
Methods
Cross-sectional study of 2651 residents in 175 French NH participating in the IQUARE study (Impact of a QUAlity process on the development of practices and the functional decline of NH REsidents) and treated with antidepressants. Diagnosis of depression was obtained from the medical records. Antidepressant treatments were identified on the prescriptions and their conformance was analyzed in light of the international practice guidelines (i.e., indication, drug class, duplication, and monitoring).
Results
A total of 1017 residents (38.4%) had a non-conforming prescription. Availability of a list of recommended medications for older patients (OR = 1.39, 95% CI [1.15; 1.68],
p
< 0.001) and regular intervention by a psychiatrist/psychiatric nurse in the facility (OR = 1.50, 95% CI [1.26; 1.77],
p
< 0.001) were associated with better antidepressant conformance. Women (OR = 0.76, 95% CI [0.61; 0.93],
p
< 0.05) and residents on multiple drugs (OR = 0.64, 95% CI [0.50; 0.80],
p
< 0.001) were at higher risk for non-conforming antidepressant prescription. A history of dementia (OR = 1.54, 95% CI [1.29; 1.84],
p
< 0.001), co-prescription of neuroleptics (OR = 4.23, 95% CI [2.20; 8.12],
p
< 0.001), and a known date of psychotropic initiation (OR = 2.58, 95% CI [2.10; 3.16],
p
< 0.001) were associated with better antidepressant conformance.
Conclusions
Our results suggest that a “quality process” by the NH combining accessible psychiatric care in facilities, pharmacological monitoring, and prescription improvement actions might optimize antidepressant prescribing for residents.]]></description><subject>Geriatrics/Gerontology</subject><subject>Internal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Research Paper</subject><issn>1878-7657</issn><issn>1878-7649</issn><issn>1878-7657</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9UUtLBDEMHkRB0f0Dnnr0MtpO59HxJosvELzouXTbdLfLbDs2HdQ_4u-1-zh4MhCSkO9LSL6iuGT0mlHa3WDN-r4vKctOmejLr6PijIlOlF3bdMd_8tNihrim2XjV9119Vvzc-eQMjBEQlU9InCd-iuj8kqzCBpDYEEkGgDfgEwmDgUhGlVyu8JakFRAdA2KJoJMLXg1EIQbt1LZCEmweicml6dC1SqcQkXy6tCLbvTq6cdsjOvi8bKO8hovixKoBYXaI58X7w_3b_Kl8eX18nt-9lJpXdSpryljdVtS0puGW1UoJYyk1vF6YtqVC214xC0xAx-kCNLeNYLpruaa8aRrDz4ur_dwxho8JMMmNQw3DoDyECWXViErQtulphlZ76O7cCFaO0W1U_JaMyq0Ocq-DzDrInQ7yK5P4noQZ7JcQ5TpMMb8B_2P9AlgakNw</recordid><startdate>20190601</startdate><enddate>20190601</enddate><creator>Abdeljalil, Anne-Bahia</creator><creator>Arbus, Christophe</creator><creator>Montastruc, François</creator><creator>de Souto Barreto, Philipe</creator><creator>André, Laurine</creator><creator>Vellas, Bruno</creator><creator>Rolland, Yves</creator><general>Springer International Publishing</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5965-387X</orcidid></search><sort><creationdate>20190601</creationdate><title>Antidepressants in nursing homes for dependent older patients: the cross-sectional associations of institutional factors with prescription conformance</title><author>Abdeljalil, Anne-Bahia ; Arbus, Christophe ; Montastruc, François ; de Souto Barreto, Philipe ; André, Laurine ; Vellas, Bruno ; Rolland, Yves</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c324t-40114620d6d53f14aa8df00d34bd6608cf9a1fe18e730bec3f581c763c03555d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Geriatrics/Gerontology</topic><topic>Internal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Research Paper</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Abdeljalil, Anne-Bahia</creatorcontrib><creatorcontrib>Arbus, Christophe</creatorcontrib><creatorcontrib>Montastruc, François</creatorcontrib><creatorcontrib>de Souto Barreto, Philipe</creatorcontrib><creatorcontrib>André, Laurine</creatorcontrib><creatorcontrib>Vellas, Bruno</creatorcontrib><creatorcontrib>Rolland, Yves</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European geriatric medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abdeljalil, Anne-Bahia</au><au>Arbus, Christophe</au><au>Montastruc, François</au><au>de Souto Barreto, Philipe</au><au>André, Laurine</au><au>Vellas, Bruno</au><au>Rolland, Yves</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Antidepressants in nursing homes for dependent older patients: the cross-sectional associations of institutional factors with prescription conformance</atitle><jtitle>European geriatric medicine</jtitle><stitle>Eur Geriatr Med</stitle><date>2019-06-01</date><risdate>2019</risdate><volume>10</volume><issue>3</issue><spage>421</spage><epage>430</epage><pages>421-430</pages><issn>1878-7657</issn><issn>1878-7649</issn><eissn>1878-7657</eissn><abstract><![CDATA[Key summary points
Aim
To determine the proportion of non-conforming antidepressant prescriptions among nursing home residents and identify the associated institutional and demographic factors.
Findings
Despite the practice guidelines, non-conforming antidepressant prescribing is still of significant concern in nursing homes, in over one-third of the residents. Institutional factors, such as simple drug prescribing actions and accessible psychiatric care, are associated with better antidepressant conformance and should be taken into account in further research.
Message
A “quality process” by the nursing home might optimize antidepressant prescribing for residents.
Purpose
Depression is diagnosed in approximately 40% of the nursing home (NH) residents, but the pertinence of the high use of antidepressants is often criticized. We aimed at determining the proportion of non-conforming antidepressant prescriptions among NH residents and the associated institutional and demographic factors.
Methods
Cross-sectional study of 2651 residents in 175 French NH participating in the IQUARE study (Impact of a QUAlity process on the development of practices and the functional decline of NH REsidents) and treated with antidepressants. Diagnosis of depression was obtained from the medical records. Antidepressant treatments were identified on the prescriptions and their conformance was analyzed in light of the international practice guidelines (i.e., indication, drug class, duplication, and monitoring).
Results
A total of 1017 residents (38.4%) had a non-conforming prescription. Availability of a list of recommended medications for older patients (OR = 1.39, 95% CI [1.15; 1.68],
p
< 0.001) and regular intervention by a psychiatrist/psychiatric nurse in the facility (OR = 1.50, 95% CI [1.26; 1.77],
p
< 0.001) were associated with better antidepressant conformance. Women (OR = 0.76, 95% CI [0.61; 0.93],
p
< 0.05) and residents on multiple drugs (OR = 0.64, 95% CI [0.50; 0.80],
p
< 0.001) were at higher risk for non-conforming antidepressant prescription. A history of dementia (OR = 1.54, 95% CI [1.29; 1.84],
p
< 0.001), co-prescription of neuroleptics (OR = 4.23, 95% CI [2.20; 8.12],
p
< 0.001), and a known date of psychotropic initiation (OR = 2.58, 95% CI [2.10; 3.16],
p
< 0.001) were associated with better antidepressant conformance.
Conclusions
Our results suggest that a “quality process” by the NH combining accessible psychiatric care in facilities, pharmacological monitoring, and prescription improvement actions might optimize antidepressant prescribing for residents.]]></abstract><cop>Cham</cop><pub>Springer International Publishing</pub><doi>10.1007/s41999-019-00189-x</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-5965-387X</orcidid></addata></record> |
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| language | eng |
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| source | SpringerLink Journals |
| subjects | Geriatrics/Gerontology Internal Medicine Medicine Medicine & Public Health Research Paper |
| title | Antidepressants in nursing homes for dependent older patients: the cross-sectional associations of institutional factors with prescription conformance |
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