Changes in drug use during a stay in a psychogeriatric nursing home

OBJECTIVE: To describe the changes in drug intake during institutionalization in a Dutch psychogeriatric nursing home. SETTING: Psychogeriatric nursing home Joachim en Anna in Nijmegen, the Netherlands. DESIGN: Retrospective analysis of medical charts. PATIENTS AND METHODS: In 390 patients drug intake (sixteen drug groups) at admission, after six weeks, at half yearly intervals and on the day of death was recorded in a longitudinal fashion, as were side effects. Increase or decrease in drug intake was tested by means of linear regression analysis. RESULTS: After an initial decrease there was a gradual increase in mean drug intake during institutionalization. Laxatives and to a lesser degree drugs for the respiratory tract and heart were mostly responsible for this increase. In the other groups no change or even decrease was noted. The degree of dependency and the type of dementia had an influence on these changes. At the day of death analgesics, morphinomimetics and bronchodilators were the most frequent drugs. Neuroleptics caused most of the side effects observed. CONCLUSION: Prescription of laxatives is mostly responsible for the increase in mean drug intake in this Dutch psychogeriatric nursing home.