Variations and factors associated with psychotropic use in cognitively impaired elderly residing in long-term care facilities in East Asia: a cross-sectional study

Saya Terada, Miyae Yamakawa, Younhee Kang, Sayuri Kobayashi, Xiao yan Liao, Sirirat Panuthai, Huei chuan Sung, Mizue Suzuki, Kiyoko Makimoto

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background: The aim of this cross-sectional study was to compare patterns of psychotropic prescription drug use among cognitively impaired residents in long-term care facilities in East Asia and to explore factors associated with these patterns. Methods: This study included elderly participants with cognitive impairments residing in long-term care facilities with and without dementia care units in Japan, South Korea, China, Taiwan, and Thailand. The Mini-Mental State Examination, the Clinical Dementia Rating, and the Neuropsychiatric Inventory, Nursing Home version were used to assess cognitive status, examine dementia severity, and evaluate behavioural psychological symptoms of dementia, respectively. The rate of psychotropic drug use and the relationship between the number of psychotropic drugs and clinical factors were examined. Results: In total, 662 people were analyzed. Facilities with dementia care units had a higher rate of anti-dementia drug use than regular elderly care sites. Among the three dementia care sites, a Japanese hospital and a Korean site had a high rate of antipsychotic use and use of other types of psychotropics, whereas these drugs were used at a low rate in a Chinese nursing home. Patterns of psychotropic drug use may be partially associated with local regulations and facility type. Poly-pharmacy was identified as a common problem at all study sites. Conclusions: Our findings will be beneficial for health-care professionals and policymakers when developing practice guidelines and strategies to regulate overuse of psychotropics and poly-pharmacy. Prospective studies are needed to examine patterns of psychotropic prescriptions and to promote evidence-based practice.

Original languageEnglish
Pages (from-to)291-299
Number of pages9
JournalPsychogeriatrics
Volume19
Issue number4
DOIs
StatePublished - Jul 2019

Bibliographical note

Funding Information:
1Division of Health Sciences, Department of Clinical Nursing, Graduate School of Medicine, Osaka University, Osaka, 3Department of Nursing, Faculty of Nursing Komazawa Women’s University, Tokyo, 7Department of Nursing, Hamamatsu University School of Medicine, Shizuoka, 8Department of Nursing, School of Nursing and Rehabilitation, Konan Women’s University, Hyogo, Japan, 2Department of Nursing, College of Nursing, Ewha Womans University, Seoul, South Korea, 4Department of Nursing, Nanfang Hospital, Guangzhou, China, 5Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand and 6Department of Nursing, Graduate Institute of Long-term Care, Tzu Chi University of Science and Technology, Hualien, Taiwan Correspondence: Professor Kiyoko Makimoto PhD, Department of Nursing, School of Nursing and Rehabilitation, Konan Women’s University, 2-23-6 Morikita-machi, Kobe, Hyogo, Japan. Email: kmakimoto@sahs.osaka-u.ac.jp Disclosure: This work is a part of the Prevalence of Symptoms of Dementia in East-Asian Cross-cultural (ePiSODIC) study and was supported by grant from Japan Society for the Promotion of Science Grants-in-Aid for Scientific Research (grant no. JP26305018). The authors have no conflicts of interest to disclose.

Publisher Copyright:
© 2019 Japanese Psychogeriatric Society

Keywords

  • East Asia
  • long-term care facilities
  • psychotropic use

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