As-Needed Prescribing and Administration of Psychotropic Medications in Assisted Living: A 7-State Study.
Paula Carder, Sheryl Zimmerman, Christopher J Wretman and 3 others
PMID 34919835WHAT IT FOUND
In assisted living, about one in ten residents had an as-needed psychotropic medication prescribed, but only 2.3% were given one in seven days.
Anxiolytic/hypnotic drugs were most common, and residents with dementia were more likely to receive them.
Key findings
01A psychotropic medication was prescribed as-needed for 10.3% of residents, while 2.3% were administered one.
02Anxiolytic/hypnotic medications made up most as-needed prescriptions: 9.1% of residents had one, compared with 1.3% prescribed an antipsychotic.
0370.5% of as-needed psychotropic prescriptions had a written indication, but none of the charts referenced nonpharmacologic options as an alternative or in advance of use.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 34% of eligible communities participated; 48% refused and 17% were pending consent at the end of the study. The chart review captured only a seven-day window, so it cannot show how often as-needed psychotropic medications were used over time. The study did not record why a medication was given, whether staff followed a policy, whether a health care professional assessed the resident before administration, or whether the medication helped or harmed the resident. The data are cross-sectional, so associations between dementia, dementia beds, or other characteristics and as-needed prescribing cannot show cause. The study included only seven states, so it may not represent assisted living practice in other states.
Declared interests
The supplied text lists NIH extramural research support. No additional funding or conflicts of interest are stated.
The easy way to misread this
Do not conclude that as-needed psychotropic medications are common or effective in assisted living. Only 10.3% of residents had an as-needed psychotropic prescription and 2.3% were administered one in the seven-day window. The study did not measure whether the medications helped or harmed residents.