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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Dr. Hendrika J. Luijendijk, University of Groningen
- Second opponent: Associate Professor Kjell H. Halvorsen, UiT - Arctic University of Norway
- Third member and chair of the evaluation committee: Professor II Toril Dammen, University of Oslo
Chair of the Defence
Professor II Bjørn Hofmann, Faculty of Medicine, University of Oslo
Principal Supervisor
Head of Research Sverre Bergh, Sykehuset Innlandet
Summary
Psychotropic drugs are widely used in nursing home residents. In older persons and in people with dementia, these drugs may cause severe adverse effects while their effect on psychological and behavioural symptoms in dementia are limited.
Few studies have performed analyses of psychotropic drug prescriptions from admission to a nursing home. The first aim of this thesis was to present prescription patterns of psychotropic drugs in nursing home residents, from admission and over a three-year period, and associations with clinical and environmental characteristics.
The Norwegian General Practice – Nursing Home criteria (NorGeP-NH) is a drug review tool specific for nursing home residents, but it has never been tested in a real-world situation. The second aim of this thesis was to test, in a randomized controlled trial, if NorGeP-NH could improve quality of life, other clinical symptoms, and psychotropic drug prescriptions in nursing homes.
Psychotropic drug prescriptions increased significantly during the first six months after nursing home admission, and it remained frequent during the follow-up. Antidepressants were the most frequently prescribed psychotropic drugs. Residents with more depressive symptoms had higher odds of receiving antidepressants, sedatives, and hypnotics. Residents with more severe dementia had lower odds of receiving sedatives and hypnotics.
NorGeP-NH did not show a significant effect on the residents’ quality of life, but it had an effect on decreasing depression. NorGeP-NH did not affect psychotropic drug prescriptions, nor their daily dosages.
To prevent prolonged and excessive psychotropic drug prescriptions, particular attention should be paid on these drugs during the first months after nursing home admission, especially in residents with depression. NorGeP-NH alone may not be as helpful in improving symptoms and medication in nursing home residents. The development of new tools to review psychotropic drugs in nursing homes may be needed.
Additional information
Contact the research support staff.