Patterns of Daily Administration of Psychoactive Drug Classes for Distress Behavior in Dementia.
Kenneth S Boockvar, Tianwen Huan, Kimberly Curyto and 2 others
PMID 41956436WHAT IT FOUND
In nursing home residents with dementia, antipsychotic and benzodiazepine administration rose sharply around documented distress behavior incidents and persisted 30 days; antidepressant and anti-epileptic classes did not show the same pattern.
Key findings
01On the day of a documented distress behavior incident, 42% of residents received antipsychotics and 20% received benzodiazepines, and increases persisted 30 days after the incident.
02Antidepressant and anti-epileptic medication classes did not show the same day-of-incident increases as antipsychotics and benzodiazepines.
03In multivariable models, incident-day benzodiazepine or antipsychotic receipt was associated with prior receipt of the same medication class and with anxiety, schizophrenia, or other psychotic disorder; prior gabapentin was inversely associated with incident-day benzodiazepine receipt.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Staff may have documented only more severe distress behavior incidents, so less severe incidents and their medication patterns could be missed. The study did not classify medication dose, route, or frequency, so dose increases during incidents were not counted. The findings come from VA long-term care facilities, so medication patterns may differ in non-VA nursing homes. Dementia subtype could not be distinguished because of data limitations. Behavioral symptoms and medication prescribing may differ by sex, and most long-term care residents outside the VA are women. Residents with incidents were more likely to have received psychoactive medications before the incident, so the observed increases may partly reflect existing treatment patterns rather than the incident alone.
Declared interests
No author reported financial conflicts of interest.
The easy way to misread this
Do not read the 42% antipsychotic and 20% benzodiazepine use on the incident day as evidence that these medications worked. The study did not report behavior outcomes after medication administration, and it only described medication patterns around documented distress behavior incidents.