• Smeets Claudia H W CHW 0000-0003-2601-274X a Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health , , Debby L Gerritsen, Sytse U Zuidema, Steven Teerenstra, Klaas van der Spek, Martin Smalbrugge, and Koopmans Raymond T C M RTCM a Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health , Radboud university medical center ,.
• a Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health , Radboud university medical center , Nijmegen , The Netherlands.
• Aging Ment Health. 2018 Sep 1; 22 (9): 1239-1246.

ObjectivesTo determine psychotropic drug prescription rates in nursing home residents with dementia and to identify associations with the so far understudied psychosocial non-resident-related factors.MethodA cross-sectional, observational, exploratory design as part of PROPER I (PRescription Optimization of Psychotropic drugs in Elderly nuRsing home patients with dementia). Participants were 559 nursing home residents with dementia, 25 physicians, and 112 nurses in the Netherlands. Psychotropic drug prescription, non-resident-related and known resident-related variables were measured to operationalize the themes of our previous qualitative analysis.ResultsFifty-six percent of residents were prescribed any psychotropic drug, 25% antipsychotics, 29% antidepressants, 15% anxiolytics, and 13% hypnotics, with large differences between the units. Multivariate multilevel regression analyses revealed that antipsychotic prescription was less likely with higher physicians' availability (odds ratio 0.96, 95% confidence interval 0.93-1.00) and that antidepressant prescription was more likely with higher satisfaction of nurses on resident contact (odds ratio 1.50, 95% confidence interval 1.00-2.25). Resident-related factors explained 6%-15% of the variance, resident- and non-resident-related factors together 8%-17%.ConclusionPrescription rates for antipsychotics are similar compared to other countries, and relatively low for antidepressants, anxiolytics, and hypnotics. Our findings indicate that improvement of prescribing could provisionally best be targeted at resident-related factors.

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