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Open Access Research article

Psychotropic medication use among nursing home residents in Austria: a cross-sectional study

Eva Mann1, Sascha Köpke2, Burkhard Haastert3, Kaisu Pitkälä4 and Gabriele Meyer5*

Author Affiliations

1 General practice and Institute for Health Services Research, Rankweil, Austria

2 Unit of Health Sciences and Education, University of Hamburg, Hamburg, Germany

3 mediStatistica, Neuenrade, Germany

4 Department of General Practice and Primary Health Care, Unit of General Practice, Helsinki University Hospital and Faculty of Medicine, University of Helsinki, Helsinki, Finland

5 Institute of Nursing Science, Faculty of Medicine, University Witten/Herdecke, Witten, Germany

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BMC Geriatrics 2009, 9:18  doi:10.1186/1471-2318-9-18

Published: 21 May 2009

Abstract

Background

The use of psychotropic medications and their adverse effects in frail elderly has been debated extensively. However, recent data from European studies show that these drugs are still frequently prescribed in nursing home residents. In Austria, prevalence data are lacking. We aimed to determine the prevalence of psychotropic medication prescription in Austrian nursing homes and to explore characteristics associated with their prescription.

Methods

Cross-sectional study and association analysis in forty-eight out of 50 nursing homes with 1844 out of a total of 2005 residents in a defined urban-rural region in Austria. Prescribed medication was retrieved from residents' charts. Psychotropic medications were coded according to the Anatomical Therapeutic Chemical Classification 2005. Cluster-adjusted multiple logistic regression analysis was performed to investigate institutional and residents' characteristics associated with prescription.

Results

Residents' mean age was 81; 73% of residents were female. Mean cluster-adjusted prevalence of residents with at least one psychotropic medication was 74.6% (95% confidence interval, CI, 72.0–77.2). A total of 45.9% (95% CI 42.7–49.1) had at least one prescription of an antipsychotic medication. Two third of all antipsychotic medications were prescribed for bedtime use only. Anxiolytics were prescribed in 22.2% (95% CI 20.0–24.5), hypnotics in 13.3% (95% CI 11.3–15.4), and antidepressants in 36.8% (95% CI 34.1–39.6) of residents. None of the institutional characteristics and only few residents' characteristics were significantly associated with psychotropic medication prescription. Permanent restlessness was positively associated with psychotropic medication prescription (AOR 1.54, 95% CI 1.32–1.79) whereas cognitive impairment was inversely associated (AOR 0.70, 95% CI 0.56–0.88).

Conclusion

Frequency of psychotropic medication prescription is high in Austrian nursing homes compared to recent published data from other countries. Interventions should aim at reduction and optimisation of prescriptions.