ABSTRACT
Five nursing homes in Bergen participated in a study of drug consumption by patients admitted for a long-term stay. The investigation was performed on admission and again after three months. During the first six months of 1991, 83 patients were admitted for a long term stay. The median drug consumption was 3.0 drugs on both occasions. On admission 8%, and after three months 3%, did not use any drug. 27%, respectively 24%, used five different drugs or more. Laxatives, diuretics, vitamins, analgetics and antipsychotic drugs were the most frequently used drugs. During the period of the study there was no change in total drug consumption. However, after three months, demented patients were treated significantly more frequently with antipsychotic drugs. Furthermore, the probability of being treated with an antipsychotic was five times higher in institutions where the physician was not engaged full time in geriatric medicine.
Subject(s)
Drug Utilization , Nursing Homes/statistics & numerical data , Aged , Female , Humans , Male , Middle Aged , Norway , Patient Admission , Time FactorsABSTRACT
A double-blind controlled trial was carried out in 73 hospitalized elderly patients to evaluate the effect of different low doses of the neuroleptic, zuclopenthixol, on behavioural disorders associated with dementia. Patients were randomized into four groups and received treatment for 4 weeks with fixed daily doses of 2 mg, 4 mg or 6 mg zuclopenthixol, or with a dose which could be increased from 4 mg to 20 mg daily. The dose could also be reduced if necessary. Fifty-four of the patients remained on the same daily dose throughout the study. The results of symptom assessments showed that there was a significant improvement from baseline scores in all of the dose groups and, with the exception of patients on 2 mg daily, this was evident after only 1 week of treatment. Although improvement was noted in all the symptoms evaluated, the best effect was achieved on aggressive behaviour, restlessness/agitation, sleep disorders, and shouts/torments others. Only a few, relatively mild side-effects were recorded and there was no increase in frequency with increasing doses. There was significant correlation between the serum concentration and the dose of zuclopenthixol used but not in connection to age and clinical efficacy.
Subject(s)
Antipsychotic Agents/administration & dosage , Clopenthixol/analogs & derivatives , Dementia/drug therapy , Aged , Aged, 80 and over , Aggression/drug effects , Clopenthixol/administration & dosage , Double-Blind Method , Drug Administration Schedule , Female , Hospitalization , Humans , Male , Psychomotor Agitation/drug therapy , Random AllocationABSTRACT
A double-blind study was carried out in 53 elderly patients in 6 geriatric nursing homes to assess the effectiveness of the neuroleptics, zuclopenthixol and melperon (flubuperone), in the relief of restlessness, aggressiveness and other such symptoms. The initial daily dose was 4 mg zuclopenthixol or 75 mg melperon, increased if necessary over the treatment period of 4 weeks. Assessments were made on entry and after 1, 2 and 4 weeks of treatment of the overall severity of illness and of individual symptoms. The results showed that there was significant improvement in the condition of patients in both treatment groups and a significant reduction in mean total as well as in the main single symptom scores. These changes were already apparent after 1 week of treatment. Although there was a tendency for faster improvement in the zuclopenthixol group, there were no significant differences between the groups in any of the parameters assessed. Side-effects were few and generally mild and transient.
Subject(s)
Antipsychotic Agents/therapeutic use , Butyrophenones/therapeutic use , Clopenthixol/therapeutic use , Mental Disorders/drug therapy , Thioxanthenes/therapeutic use , Aged , Aged, 80 and over , Aggression/drug effects , Antipsychotic Agents/adverse effects , Butyrophenones/adverse effects , Clinical Trials as Topic , Clopenthixol/adverse effects , Clopenthixol/analogs & derivatives , Double-Blind Method , Female , Hostility/drug effects , Humans , Male , Mental Disorders/psychology , Psychomotor Agitation/drug therapy , Random AllocationABSTRACT
Dementia and work load were estimated in 4736 elderly home-nursed or institutionalized persons. Mental status was estimated by means of the Clinical Dementia Rating scale (CDR), and work load by means of a traditional work load scale. Approximately one third of elderly over 85 years were living in an institution. 4.6% of the population over 65 years of age were moderately to severely and 1.8% mildly demented. Work load increased with increasing dementia. In homes for the aged 40% and in nursing homes 85% of the residents create a heavy work load. 14.5% of the estimated population are considered misplaced, the majority of whom should be transferred to a higher care level. Dementias cause a major problem on every care level. Services which are lacking for this group and necessary rehabilitation facilities should be provided.
