Melatonin Prescribing in Assisted Living.
Punita Peketi, Sheryl Zimmerman, Stephanie Palmertree and 3 others
PMID 34762846WHAT IT FOUND
Melatonin was prescribed in 82% of assisted living communities, but to only 9% of residents overall.
Prescribing was higher in facilities with on-site nurses and supervisors who favored non-drug approaches. It was frequently coprescribed with antidepressants and anxiety medications.
Key findings
01An estimated 82% of assisted living communities prescribed melatonin to at least one resident, averaging 9% of residents per community.
02Melatonin prescribing was significantly higher in communities with an on-site nurse and in those where health care supervisors held more favorable attitudes toward nonpharmacologic practices.
03Melatonin was commonly coprescribed with other psychotropic medications, particularly antidepressants, with an odds ratio of 2.64.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Data relied on chart completeness, which varies in assisted living compared to nursing homes. The study is observational and cannot determine if melatonin was effective or if it replaced other sleep medications. Melatonin is a supplement in the US, so quality and actual dosage may vary from what is recorded.
Declared interests
The authors declare no conflicts of interest. The study was supported by the NIH.
The easy way to misread this
Do not interpret the higher prescribing rates in communities with nurses as evidence that nurse-led care increases unnecessary medication. The data shows an association, but the authors note this may reflect nurses' role in managing complex cases or their preference for nonpharmacologic approaches in general, rather than causing more melatonin use.