High nurse workload may increase inappropriate psychotropic prescribing in SNFs, study says

Share this content:

Older nursing home residents and those with more severe psychiatric symptoms may receive more appropriate psychotropic prescriptions than others, a new study suggests.

Conducted by Dutch researchers, the study included a sample of nearly 350 nursing home residents with a psychotropic drug prescription and dementia. The goal was to identify possible patient and non-patient drivers behind prescribing, researchers said.

The team's findings, published online Thursday in International Psychogeriatrics, showed that older residents and those with more severe aggression, depression and agitation were more likely to receive an appropriate psychotropic prescription. Less appropriate prescriptions were identified when residents had more severe anxiety, a diagnosis of dementia other than Alzheimer's, and more time spent with a physician.

The more patients and years of experience a physician had, as well as the higher the nursing staff's workload, was also found to be associated with inappropriate prescribing.

The link between more pronounced symptoms and more appropriate prescribing “implies that physicians should pay more attention to the appropriateness” of prescriptions when symptoms are less obvious, the researchers said. The researchers also acknowledged that some of their findings may seem counterintuitive, and require more research before concrete recommendations can be made.