Psychotropic Drug Prescription in Nursing Homes During the COVID-19 Pandemic

• Published in: Drugs & aging Vol. 39; no. 6; pp. 467 - 475
• Main Authors: Ferro Uriguen, Alexander, Laso Lucas, Esther, Sannino Menicucci, Cinzia, Iturrioz Arrechea, Izaskun, Alaba Trueba, Javier, Echevarría Orella, Enrique, Gil Goikouria, Javier, Beobide Telleria, Idoia
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.06.2022; Springer Nature B.V
• Subjects: Antidepressants; Behavior disorders; Coronaviruses; COVID-19; Dementia; Elder care; Geriatric psychiatry; Geriatrics/Gerontology; Internal Medicine; Medicine; Medicine & Public Health; Mortality; Nursing homes; Original; Original Research Article; Pandemics; Pharmacology/Toxicology; Pharmacotherapy; Psychotropic drugs; Spain
• ISSN: 1170-229X; 1179-1969
• DOI: 10.1007/s40266-022-00948-9

Background To limit the introduction of coronavirus disease 2019 (COVID-19) into nursing homes, restrictive measures and social distancing were implemented; however, these caused an increase in affective disorders such as depression and anxiety and an alteration of the behavioral and psychological symptoms of dementia. Therefore, it is expected that prescription trends of psychotropic drugs in nursing homes during the pandemic may have changed significantly. Objective This study aims to compare patterns of prescribing psychotropic drugs in nursing homes during the COVID-19 pandemic to those of the pre-pandemic period. Methods This cross-sectional multicenter study was conducted in geriatric units and psychogeriatric units in seven nursing homes in Gipuzkoa, Spain. On 1 March, 2020, data regarding 511 residents in geriatric units and 163 in psychogeriatric units were recorded. This study examined utilization percentages for psychotropic drugs before the pandemic (April 2018–March 2020) and during the pandemic (April 2020–March 2021) in light of projected usage based on previous years. Following the Anatomical, Therapeutic, Chemical Classification System, four therapeutic groups were analyzed: antipsychotics (N05A), benzodiazepines (N05B and N05C), antidepressants (N06A), and antiepileptic drugs (N03A). Results In the case of geriatric units, a downward trend of prescription was reversed for antipsychotics (−0.41; 95% confidence interval [CI] −1.41, 0.60). Benzodiazepine use also decreased less than expected (−2.00; 95% CI −3.00, −1.00). Antidepressant use increased more than predicted (0.02; 95% CI −0.97, 1.01), as did antiepileptic drug use (2.93; 95% CI 2.27, 3.60). In the psychogeriatric units, the drop in antipsychotic utilization was less than expected (−2.31; 95% CI −3.68, −0.93). Although it was expected that the prescription of benzodiazepines would decrease, usage remained roughly the same (−0.28; 95% CI −2.40, 2.34). Utilization of antidepressants (8.57; 95% CI 6.89, 10.24) and antiepileptic drugs (6.10; 95% CI 3.20, 9.00) increased significantly, which was expected, based on the forecast. Conclusions For all categories, usage of psychotropic drugs was higher than anticipated based on the forecast; this increase might be related to the worsening of emotional and behavioral disorders caused by the restrictive measures of the COVID-19 pandemic.