[Pharmacotherapy of neuropsychiatric symptoms in dementia in nursing homes: a comparison of service provision by psychiatric outpatient clinics and primary care psychiatrists]

Psychiatr Prax. 2010 May;37(4):196-8. doi: 10.1055/s-0029-1223475. Epub 2010 Mar 11.
[Article in German]

Abstract

Background: Neuropsychiatric symptoms of dementia like agitation, depression and apathy often result in increased prescriptions of psychotropics. In Germany, outpatient clinics at psychiatric hospitals play an important role in the treatment of neuropsychiatric symptoms in nursing homes. The aim of this study was to test whether the severity and pharmacotherapy differed in patients treated by outpatient clinics at psychiatric hospitals, as compared to primary care specialists.

Methods: A cross-sectional study of the prevalence of agitation, apathy, and depression, and the amount of psychotropics prescribed in defined daily dosages (DDD) in 304 residents with dementia in 18 Berlin nursing homes.

Results: Patients treated by outpatient clinics at psychiatric hospitals suffered from more severe neuropsychiatric symptoms (p < 0.05), were prescribed more antidepressants and antidementia agents (p < 0.05) and, when adjusting for the severity of agitation, less neuroleptics (p < 0.05) as compared to primary care specialists.

Conclusion: Psychiatric outpatient clinics at hospitals treat more severely demented patients who suffer from severe neuropsychiatric symptoms. The pharmacotherapy provided by these clinics displays a favourable profile according to established treatment guidelines.

Publication types

  • Comparative Study
  • English Abstract

MeSH terms

  • Aged
  • Aged, 80 and over
  • Ambulatory Care
  • Antidepressive Agents / therapeutic use
  • Antipsychotic Agents / therapeutic use
  • Cross-Sectional Studies
  • Dementia / drug therapy*
  • Dementia / psychology
  • Drug Utilization / statistics & numerical data
  • Female
  • Germany
  • Homes for the Aged
  • Hospitals, Psychiatric
  • Humans
  • Male
  • Mental Disorders / drug therapy*
  • Mental Disorders / psychology
  • Mental Status Schedule
  • Nootropic Agents / therapeutic use
  • Nursing Homes
  • Outpatient Clinics, Hospital
  • Practice Patterns, Physicians'
  • Primary Health Care
  • Psychomotor Agitation / drug therapy
  • Psychomotor Agitation / psychology
  • Psychotropic Drugs / therapeutic use*

Substances

  • Antidepressive Agents
  • Antipsychotic Agents
  • Nootropic Agents
  • Psychotropic Drugs