[Reduction of drug intake following admission to a psychogeriatric nursing home: discontinuation is possible].

OBJECTIVE

To describe the changes in de first six weeks after admission and to consider the factors which influence drug intake.

METHODS

Psychogeriatric nursing home facility Joachim en Anna in Nijmegen, the Netherlands.

METHODS

Retrospective analysis of medical charts.

METHODS

Of 356 patients drug intake on the day of admission and six weeks after were registered as well as diagnosis on dementia, domicile before admission, degree of dependence and comorbidity. Medication was divided into sixteen groups. Changes in drug taking were tested by means of the Wilcoxon test. The influence of the factors mentioned was analysed by an analysis of variance and the logistic regression procedure.

RESULTS

The mean number of drugs taken per patient decreased from 2.5 at admission to 2.1 at six weeks. In particular psychotropics, diuretics, cardiac drugs and drugs grouped as a 'miscellaneous' were reduced. Domicile before admission, diagnosis of dementia, comorbidity and less significantly the degree of dependence all had an influence on drug intake. Patients admitted from old people's homes or a general hospital had twice as much medication as patients who lived in their own homes. Main differences were seen in the use of psychotropics and diuretics. Patients suffering from Alzheimer's disease used fewer drugs than patients with a multi-infarct dementia. The latter had a higher intake of diuretics, cardiac drugs and laxatives, while Alzheimer patients used more psychotropics. Patients with the highest degree of dependence used more laxatives and fewer psychotropics or diuretics.

CONCLUSIONS

Reduction of drug intake after admission to a psychogeriatric nursing home is possible. Several factors influence drug intake. These should be considered when comparing different studies.