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.
Bibliographical noteFunding 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: firstname.lastname@example.org 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.
© 2019 Japanese Psychogeriatric Society
- East Asia
- long-term care facilities
- psychotropic use