Claudia H W Smeets1, Martin Smalbrugge2, Sytse U Zuidema3, Els Derksen4, Erica de Vries4, Klaas van der Spek4, Raymond T C M Koopmans5, Debby L Gerritsen6. 1. Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: claudia.smeets@radboudumc.nl. 2. Department of General Practice and Elderly Care Medicine/EMGO + Institute for Health and Care Research, VU Medical Center, Amsterdam, The Netherlands. 3. Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 4. Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Center, Nijmegen, The Netherlands. 5. Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Center, Nijmegen, The Netherlands; Joachim en Anna, Center for Specialized Geriatric Care, Nijmegen, The Netherlands. 6. Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: debby.gerritsen@radboudumc.nl.
Abstract
OBJECTIVES: The objective of this study is to explore factors that elucidate reasons for psychotropic drug (PD) prescription for neuropsychiatric symptoms (NPS) in nursing home (NH) residents with dementia. DESIGN: A qualitative study using a grounded theory approach. SETTING: Twelve NHs in The Netherlands. PARTICIPANTS: Fifteen physicians and 14 nurses. MEASUREMENTS: Individual, face-to-face, in-depth semistructured interviews. Interviews were audio recorded, transcribed, and qualitatively analyzed using Atlas.ti. RESULTS: The qualitative analysis revealed 4 emerging themes with factors either or both enhancing or limiting PD prescription, which we used to develop a conceptual framework. First, the mindset of physicians and nurses toward NPS and PDs appeared to contribute. Second, inadequate knowledge of and experience with NPS and limited people skills of nurses may induce PD prescription. Also, knowledge of effectiveness and side effects of PDs from education, literature, and guidelines, and previous personal experiences was considered relevant. Third, effective communication and cooperation between professionals and with family may improve the appropriateness of PD prescription. Fourth, external factors including staffing issues, nursing home setting, access to consultants, national and local policies, and zeitgeist were considered to affect PD prescription. CONCLUSION: We have developed a conceptual framework explaining how different factors influence PD prescription. This provides opportunities for improving PD prescription in NH residents with dementia.
OBJECTIVES: The objective of this study is to explore factors that elucidate reasons for psychotropic drug (PD) prescription for neuropsychiatric symptoms (NPS) in nursing home (NH) residents with dementia. DESIGN: A qualitative study using a grounded theory approach. SETTING: Twelve NHs in The Netherlands. PARTICIPANTS: Fifteen physicians and 14 nurses. MEASUREMENTS: Individual, face-to-face, in-depth semistructured interviews. Interviews were audio recorded, transcribed, and qualitatively analyzed using Atlas.ti. RESULTS: The qualitative analysis revealed 4 emerging themes with factors either or both enhancing or limiting PD prescription, which we used to develop a conceptual framework. First, the mindset of physicians and nurses toward NPS and PDs appeared to contribute. Second, inadequate knowledge of and experience with NPS and limited people skills of nurses may induce PD prescription. Also, knowledge of effectiveness and side effects of PDs from education, literature, and guidelines, and previous personal experiences was considered relevant. Third, effective communication and cooperation between professionals and with family may improve the appropriateness of PD prescription. Fourth, external factors including staffing issues, nursing home setting, access to consultants, national and local policies, and zeitgeist were considered to affect PD prescription. CONCLUSION: We have developed a conceptual framework explaining how different factors influence PD prescription. This provides opportunities for improving PD prescription in NH residents with dementia.
Authors: Claudia M Groot Kormelinck; Charlotte F van Teunenbroek; Boudewijn J Kollen; Margreet Reitsma; Debby L Gerritsen; Martin Smalbrugge; Sytse U Zuidema Journal: BMC Psychiatry Date: 2019-10-12 Impact factor: 3.630
Authors: Margaretha T Dijk; Sarah Tabak; Cees M P M Hertogh; Rob M Kok; Rob J van Marum; Sytse U Zuidema; Eefje M Sizoo; Martin Smalbrugge Journal: Age Ageing Date: 2022-09-02 Impact factor: 12.782
Authors: Aisling A Jennings; Tony Foley; Kieran A Walsh; Alice Coffey; John P Browne; Colin P Bradley Journal: Int J Geriatr Psychiatry Date: 2018-06-13 Impact factor: 3.485