Year of Publication

2013

College

Martin School of Public Policy and Administration

Executive Summary

Purpose: In Scotland, care homes provide assisted living and medical services. Psychotropic medications (antipsychotics, anxiolytics, and hypnotics) may be over utilized in these facilities. This study compared psychotropic medication utilization in elderly care home residents to the equivalent population of non-care home residents. It is hypothesized that patients in care homes utilize psychotropic medications more than non-care home residents.

Methods: Demographic and prescription information for all patients aged 65 years and older on January 1, 2011 who received at least one prescription for a psychotropic medication during 2011 was retrieved from the national Prescribing Information System (PIS). Patients were grouped into care home and non-care home populations and were stratified by gender and 10-year age band. Estimates of the total non-care home and care home populations were made using National Records of Scotland information and, using PIS, by counting all individuals resident in a care home who had received at least one prescription of any type during 2011. Relative risk of receiving psychotropics, percent of population treated, and other utilization measures were calculated. Statistical significance was determined by p< 0.05 utilizing a paired two-sample t-test.

Results: A total of 879,492 patients were included, 32,372 of whom resided in care homes (3.7%). Males comprised 28% and 43% of the care home and non-care home populations, respectively. Age groups 65-74, 75-84, and 85+ made up 12%, 35%, and 53% of the care home population, respectively, while making up 55%, 34%, and 11% of the non-care home population, respectively. More care home patients were treated with psychotropics than non-care home patients (41.6% vs. 12.1%, p

Conclusion: Residents of care homes have increased use of psychotropic medications compared to individuals not in care homes. There are significant differences in the use of psychotropic medications based on gender and age. Whether this reflects appropriate prescribing warrants further investigation.

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