Aim To determine the prevalence of psychotropic medication
prescribing in elderly nursing home residents in Slovenia
and to explore the residents’, physicians’, and nursing
home characteristics ...associated with prescribing.
Methods In a cross-sectional study, we collected the data
for 2040 nursing home residents aged 65 years and older
in 12 nursing homes in Slovenia between September 25
and November 30, 2006. Prescribed medications lists were
retrieved from patients’ medical records. Psychotropic
medications were coded according to Anatomical Therapeutic
Chemical Classification 2005, which we adjusted for
the purposes of the study. Multivariate logistic regression
analysis was performed to determine the residents’, physicians’,
and nursing home characteristics associated with
prescribing.
Results Residents were from 65 to 104 years old (median,
83 years) and 1606 (79%) of them were female. A total
of 970 (48%) residents had dementia and 466 had depression
(23%). In 1492 (73%) residents, at least one psychotropic
medication was prescribed. Nine hundred sixty residents
were prescribed hypnotics and sedatives (47%), 572
(28%) antipsychotics, 460 (23%) antidepressants, and 432
(21%) anxiolytics. Residents’ characteristics associated with
psychotropic medication use were female sex (odds ratio
OR, 1.36; 95% confidence interval CI, 1.03-1.80), age (OR,
0.97; 95% CI, 0.95-0.98), permanent restlessness (OR, 2.54;
95% CI, 1.71-3.78), dementia (OR, 1.76; 95% CI, 1.33-2.34),
depression (OR, 5.51; 95% CI, 3.50-7.58), and the number
of prescribed medications (OR, 1.29; 95% CI, 1.23-1.35). Of
physicians’ characteristics (sex, age, specialization in general
practice, years of working experiences as a general
practitioner, and years of experiences working in a nursing
home), male sex was associated with psychotropic medication
prescribing (OR, 1.80; 95% CI, 1.17-2.76).
Conclusion Frequency of psychotropic medication prescribing
in elderly nursing home residents in Slovenia is
high and is comparable to Western European countries.
Our next step should be optimizing the prescribing in patients
with the highest prescription rate.
With a cross-sectional survey wich was held on in Slovenia we would like to define the predictors of high prescribing rates in family practice. 42 involved family doctors reported 300 office ...contacts, i.e. a total of 12,596 contacts. The participants were asked to fulfil the questionnaire for each patient-doctor encounter in one day. In 12,596 recorded contacts, 14.485 prescriptions were issued to the patients. The patients got from 0 to 10 prescriptions per visit (X±SD: 1.2±1.4). Among 7,363 (58.5%) patients, who got at least one prescription, the mean number of prescriptions was 2.0±1.4. The majority of prescribed drugs were for cardiovascular system. The multivariate model for higher number of prescribed drugs explained 20.2% of the variation. Independent predictors for higher prescribing rates during a consultation were female sex, older age, higher number of problems dealt within the consultation (comorbidity), longer consultation times, lower education grade, higher patient quota on the list, higher prescribing quota indexed by NHII for the past year, being a specialist in family medicine, male doctor and age of doctor more than 44 years. Practice characteristics did not show any correlations with high prescribing volumes. The results of this survey show that some patients’ and doctors’ characteristics and also some consultations’ characteristics affect the prescribing rate. Additional analyses should be performed to identify reasons for that and to propose proper actions.
