Use of psychotropic drugs in homes for the aged in Bergen, Norway: A comparative study

Study objectives: To compare the regular use of psychotropic drugs in 1985 and 1996 in homes for the aged in Bergen, Norway and to study the relation between age, gender, mental impairment and certain behaviour traits and psychotropic drug use. Design: A point prevalence survey performed on two occasions in 1985 and 1996. Setting: All regularly used psychotropic drugs and demographic information were collected from the case notes. Mental capacity, which was assessed by means of the Clinical Dementia Rating Scale (CDR), and behaviour were registered by a trained nurse. Participants: Thirteen representative homes for the aged with a total of 339 residents in 1985 and 286 residents in 1996. Main results: The was a significant increased use of psychotropic drugs from 1985 to 1996, 48% to 61% of the residents (p = 0.002). The use of anxiolytics and antidepressants increased significantly (5% to 14%, p=0.0004 and 12% to 23%, p=0.0005, respectively), while antipsychotics and hypnotics remained stable (24% on both occasions and 22% and 27%, respectively). The use of anxiolytics and neuroleptics was associated with anxiety, wandering and aggressive behaviour. Anxiolytics were more frequently use by mentally unimpaired residents. A substantial number of passive and apathetic residents were treated inappropriately with psychotropic drugs. Conclusion: During several years educational programs for nurses and physicians have been carried out to improve the general care and drug treatment of the elderly, especially with regard to psychotropic drugs. The anticipated changes in the use of psychotropic drugs have not been fulfilled.