transmission

Long-stay nursing home residents were more depressed during the pandemic and treated more often with drugs that work on the central nervous system, according to a study across Michigan facilities. The results should prompt nursing home clinicians to consider medication reviews and dose reduction at this time, investigators say.

Study participants included more than 37,000 nursing home residents with dementia. Most were female, aged 80 years or older, white and resided in a for-profit facility. Data came from Minimum Data Set assessments between Jan. 1, 2018 and June 30, 2021. Residents who had schizophrenia, Tourette syndrome or Huntington’s disease were not included.

Treatment rates rise

The percent of residents with moderate depressive symptoms increased during COVID-19 when compared to pre-COVID-19, as did the use of antidepressant, antianxiety, antipsychotic and opioid medications, according to Lauren B. Gerlach DO, MS, of the University of Michigan in Ann Arbor.

The increased use of antipsychotic and antianxiety medications was not observed in a prior study of data from only four months into the pandemic. But the bump in both antidepressant and opioid use was the same throughout. There were no significant changes in the use of hypnotic medications or in the amount of residents’ behavioral symptoms, the authors added.

Medication review

Considering the findings, ”careful consideration should be given to whether these medications need to be continued,” Gerlach and colleagues wrote. They recommended that clinicians make an effort to begin gradual dose reduction when appropriate.

The authors also called for more cautious enactment of policies that increase social isolation and reduce social contact. If necessary, such policies should be counterbalanced with interventions that reduce the negative impacts on residents with Alzheimer’s disease and related dementias, they concluded.

Full findings were published in the Journal of the American Geriatrics Society.

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