Psychotropic Medication Use and Changes During Hospitalization for Older Adults Living With Dementia.
Barbara Resnick, Marie Boltz, Elizabeth Galik and 6 others
PMID 37129107WHAT IT FOUND
Psychotropic medication use did not decrease during hospitalization for older adults with dementia.
Antipsychotic use increased significantly from 16% to 21%, while other drug classes remained stable. There was little evidence of deprescribing or dose reduction during the stay.
Key findings
01Antipsychotic medication use increased significantly from 16% on admission to 21% at discharge, while use of antidepressants, antianxiety medications, and opioids showed no significant change.
02There was very little evidence of deprescribing through dose reduction, with only six specific instances of decreased dosages across the entire sample.
03The study's hypothesis that psychotropic medication use would decrease from admission to discharge was not supported, indicating persistent use among hospitalized older adults with dementia.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a secondary analysis of data from a trial focused on physical activity, not medication management, so the study did not include an intervention aimed at deprescribing. The reasons for medication changes were not collected, making it impossible to determine if the increases or decreases were clinically appropriate. The data did not include "as needed" medications or information on patient response to the drugs. The sample was small (308 participants) and drawn from only two states during the COVID-19 pandemic, which may have affected medication management priorities.
Declared interests
The authors declared no potential conflicts of interest. The study was supported by the National Institute of Nursing Research.
The easy way to misread this
Do not assume the increase in antipsychotic use was inappropriate or harmful, as the study did not collect data on the clinical rationale for these changes. The findings describe what happened to medication orders, not whether those orders were clinically justified.