BACKGROUND: To clarify physicians' actual practice in treating agitation in the nursing home and to elucidate the relationship between background factors, familiarity with interventions, and practice. METHODS: A survey of actual practice for agitation in persons with dementia was administered to 67 physicians aged 31-70+ working in nursing homes in Israel. Questionnaires were administered by personal interview, self-completed, or a combination of the two. RESULTS: Psychotropic medications are prescribed by 92.5% of physicians for treating agitation, most notably, Haloperidol (39%). Non-pharmacological treatment was also reported to be common, though to a lesser extent, with environmental change being the most prevalent non-pharmacological intervention. Generally, physicians showed low familiarity levels with non-pharmacological interventions, with higher levels noted for physicians with a specialty in geriatrics compared to those who were non-specialized. Physicians who were non-Israeli and younger also reported higher familiarity levels compared to their respective counterparts (i.e. Israeli and older) but this difference did not reach significance. CONCLUSION: The findings indicate that, despite current guidelines, psychotropic medications are the treatment of choice among nursing home physicians in Israel. While rates of use of non-pharmacological interventions are substantial, their in-practice application may be hindered by lack of familiarity as well as system barriers. The results have implications for system and education changes.
BACKGROUND: To clarify physicians' actual practice in treating agitation in the nursing home and to elucidate the relationship between background factors, familiarity with interventions, and practice. METHODS: A survey of actual practice for agitation in persons with dementia was administered to 67 physicians aged 31-70+ working in nursing homes in Israel. Questionnaires were administered by personal interview, self-completed, or a combination of the two. RESULTS: Psychotropic medications are prescribed by 92.5% of physicians for treating agitation, most notably, Haloperidol (39%). Non-pharmacological treatment was also reported to be common, though to a lesser extent, with environmental change being the most prevalent non-pharmacological intervention. Generally, physicians showed low familiarity levels with non-pharmacological interventions, with higher levels noted for physicians with a specialty in geriatrics compared to those who were non-specialized. Physicians who were non-Israeli and younger also reported higher familiarity levels compared to their respective counterparts (i.e. Israeli and older) but this difference did not reach significance. CONCLUSION: The findings indicate that, despite current guidelines, psychotropic medications are the treatment of choice among nursing home physicians in Israel. While rates of use of non-pharmacological interventions are substantial, their in-practice application may be hindered by lack of familiarity as well as system barriers. The results have implications for system and education changes.
Authors: Ann Kolanowski; Richard H Fortinsky; Margaret Calkins; Davangere P Devanand; Elizabeth Gould; Tamar Heller; Nancy A Hodgson; Helen C Kales; Jeffrey Kaye; Constantine Lyketsos; Barbara Resnick; Melanie Schicker; Sheryl Zimmerman Journal: J Am Med Dir Assoc Date: 2018-08-23 Impact factor: 4.669
Authors: Willem S Eikelboom; Ellen Singleton; Esther van den Berg; Michiel Coesmans; Francesco Mattace Raso; Rozemarijn L van Bruchem; Jeannette A Goudzwaard; Frank Jan de Jong; Marc Koopmanschap; Tom den Heijer; Jan J M Driesen; Lilian J H M Vroegindeweij; Elsbeth C Thomeer; Susanne E Hoogers; Anke A Dijkstra; Sytse U Zuidema; Yolande A L Pijnenburg; Philip Scheltens; John C van Swieten; Rik Ossenkoppele; Janne M Papma Journal: Alzheimers Res Ther Date: 2019-05-24 Impact factor: 6.982