Efficacy and safety of atypical antipsychotics for behavioral symptoms of dementia among patients residing in long-term care

2017 ◽  
Vol 40 (1) ◽  
pp. 135-142 ◽  
Author(s):  
A. S. Sturm ◽  
K. E. Trinkley ◽  
K. Porter ◽  
Milap C. Nahata
Keyword(s):  
Atypical Antipsychotics ◽  
Long Term Care ◽  
Behavioral Symptoms ◽  
Efficacy And Safety ◽  
Term Care

scholarly journals Pharmacological treatments for neuropsychiatric symptoms of dementia in long-term care: a systematic review

2012 ◽  
Vol 25 (2) ◽  
pp. 185-203 ◽  
Author(s):  
Dallas P. Seitz ◽  
Sudeep S. Gill ◽  
Nathan Herrmann ◽  
Sarah Brisbin ◽  
Mark J. Rapoport ◽  
...  
Keyword(s):  
Adverse Events ◽  
Atypical Antipsychotics ◽  
Long Term Care ◽  
Neuropsychiatric Symptoms ◽  
Cochrane Library ◽  
Study Quality ◽  
Efficacy And Safety ◽  
Pharmacological Treatments ◽  
Term Care

ABSTRACTBackground: Medications are frequently prescribed for neuropsychiatric symptoms (NPS) associated with dementia, although information on the efficacy and safety of medications for NPS specifically in long-term care (LTC) settings is limited. The objective of this study was to provide a current review of the efficacy and safety of pharmacological treatments for NPS in LTC.Methods: We searched MEDLINE, EMBASE, PsychINFO, and the Cochrane Library for randomized controlled trials comparing medications with either placebo or other interventions in LTC. Study quality was described using the Cochrane collaboration risk of bias tool. The efficacy of medications was evaluated using NPS symptom rating scales. Safety was evaluated through rates of trial withdrawals, trial withdrawals due to adverse events, and mortality.Results: A total of 29 studies met inclusion criteria. The most common medications evaluated in studies were atypical antipsychotics (N = 15), typical antipsychotics (N = 7), anticonvulsants (N = 4), and cholinesterase inhibitors (N = 3). Statistically significant improvements in NPS were noted in some studies evaluating risperidone, olanzapine, and single studies of aripiprazole, carbamazepine, estrogen, cyproterone, propranolol, and prazosin. Study quality was difficult to rate in many cases due to incomplete reporting of details. Some studies reported higher rates of trial withdrawals, adverse events, and mortality associated with medications.Conclusions: We conclude that there is limited evidence to support the use of some atypical antipsychotics and other medications for NPS in LTC populations. However, the generally modest efficacy and risks of adverse events highlight the need for the development of safe and effective pharmacological and non-pharmacological interventions for this population.

scholarly journals Use of Atypical Antipsychotics in Long-Term Care Residents with Parkinson’s Disease and Comorbid Depression

2020 ◽  
Vol Volume 12 ◽  
pp. 23-30 ◽  
Author(s):  
Farid Chekani ◽  
Holly M Holmes ◽  
Michael L Johnson ◽  
Hua Chen ◽  
Jeffrey T Sherer ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Atypical Antipsychotics ◽  
Long Term Care ◽  
Comorbid Depression ◽  
Term Care

scholarly journals Monitoring changes in the organization of Dutch long-term care and their effects on the mental health and wellbeing of people with dementia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H van der Roest ◽  
M Prins ◽  
J van Erp ◽  
E Hartstra ◽  
A van der Schot
Keyword(s):  
Quality Of Life ◽  
Cognitive Impairment ◽  
Nursing Homes ◽  
Long Term Care ◽  
Behavioral Symptoms ◽  
Term Care ◽  
People With Dementia ◽  
Over Time

Abstract Background The 'Living Arrangements for People with Dementia (LAFD)' monitor-study aims to provide insight into effects of changes in the organization of Dutch long-term care for people with dementia. The objective of this study is to evaluate changes over time in the level of cognitive impairment, the frequency and severity of behavioral symptoms, and quality of life of residents with dementia, and changes in staffing levels. The study allows for detection of trends and developments that are relevant for the quality of nursing home care. Methods The LAFD-study is a repeated cross-sectional study. Since 2008, assessments have been conducted in participating nursing homes every two year. Up to 2020, five assessments have been completed. The number of participating nursing homes over time ranged from 47 to 144 and a sample of one third of residents was included in the study. Data collection was performed by care professionals. Cognitive impairment was assessed with the Cognitive Performance Scale, frequency and severity of behavioral symptoms were assessed with the Neuropsychiatric Inventory; quality of life was assessed with de Qualidem. Per nursing home, the amount of direct provided care was inventoried. Results Assessments up to 2017/2018 showed an improvement in cognitive functioning and quality of life in Dutch nursing homes. The amount of behavioral problems did not change, as did the amount of direct care. However, the level of professional caregivers increased slightly. In the last assessment, 53 nursing homes participated, and 668 residents were included. The fast majority of participants was over 80 years of age (67.1%) and 68.5% were female. The data are currently being further analyzed and presented at the conference. Conclusions There is a trend of improvement in cognitive functioning and quality of life up to 2018. The most recent assessment will indicate whether these positive trends continue.

Abstract #285: Optimizing Insulin Therapy in Older Adults in the Long-Term Care Setting: An Efficacy and Safety Comparator Analysis

2016 ◽  
Vol 22 ◽  
pp. 76
Author(s):  
Alan Boonin ◽  
Brenda Balinski ◽  
Jerry Sauter ◽  
Hao Chen ◽  
Scott Abbott ◽  
...  
Keyword(s):  
Older Adults ◽  
Insulin Therapy ◽  
Care Setting ◽  
Long Term Care ◽  
Efficacy And Safety ◽  
Term Care

The determinants of behavioral symptoms in long-term care facility residents

2016 ◽  
Vol 7 (2) ◽  
pp. 157-162 ◽  
Author(s):  
U. Pawłucka ◽  
P. Brzyski ◽  
D. Kubicz ◽  
K. Szczerbińska
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
Behavioral Symptoms ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

scholarly journals BEHAVIORAL SYMPTOMS AND FALLS IN LONG-TERM CARE FACILITIES: PERCEPTIONS OF GERONTECHNOLOGY

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 287-287 ◽  
Author(s):  
A. Bourbonnais ◽  
J. Rousseau ◽  
J. Meunier ◽  
M. Gagnon ◽  
M. Lalonde ◽  
...  
Keyword(s):  
Long Term Care ◽  
Behavioral Symptoms ◽  
Term Care ◽  
Care Facilities

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

2020 ◽  
Vol 11 (5) ◽  
pp. 761-775
Author(s):  
Violetta Kijowska ◽  
Ilona Barańska ◽  
Katarzyna Szczerbińska
Keyword(s):  
Cognitive Impairment ◽  
Atypical Antipsychotics ◽  
Long Term Care ◽  
Multiple Correspondence Analysis ◽  
Prescribing Practices ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Term Care ◽  
Factors Associated

Abstract 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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