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Pottegård A, Lundby C, Jarbøl DE, et al. Use of sedating medications around nursing home admission in Denmark. Pharmacoepidemiol Drug Saf. 2021;30(11):1560-1565doi: 10.1002/pds.5341.
Pottegård, A., Lundby, C., Jarbøl, D. E., Larsen, S. P., Hoppe, B. C., Hoffmann, H., & Thompson, W. (2021). Use of sedating medications around nursing home admission in Denmark. Pharmacoepidemiology and drug safety, 30(11), 1560-1565. https://doi.org/10.1002/pds.5341
Pottegård, Anton, et al. "Use of sedating medications around nursing home admission in Denmark." Pharmacoepidemiology and drug safety vol. 30,11 (2021): 1560-1565. doi: https://doi.org/10.1002/pds.5341
Pottegård A, Lundby C, Jarbøl DE, Larsen SP, Hoppe BC, Hoffmann H, Thompson W. Use of sedating medications around nursing home admission in Denmark. Pharmacoepidemiol Drug Saf. 2021 Nov;30(11):1560-1565. doi: 10.1002/pds.5341. Epub 2021 Aug 22. PMID: 34382278.
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Pharmacoepidemiol Drug Saf. 2021 Nov;30(11):1560-1565. doi: 10.1002/pds.5341. Epub 2021 Aug 22.

Use of sedating medications around nursing home admission in Denmark.

Pharmacoepidemiology and drug safety

Anton Pottegård, Carina Lundby, Dorte Ejg Jarbøl, Søren Post Larsen, Bettina Clauber Hoppe, Helene Hoffmann, Wade Thompson

Affiliations

  1. Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark.
  2. Hospital Pharmacy Funen, Odense University Hospital, Odense, Denmark.
  3. Odense Deprescribing Initiative (ODIN), Odense, Denmark.
  4. Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
  5. TYPE2DIALOG, Kongens Lyngby, Denmark.

PMID: 34382278 DOI: 10.1002/pds.5341

Abstract

PURPOSE: To examine use of sedating medications around the time of nursing home admission in Denmark.

METHODS: We conducted a register-based drug utilization study, describing patterns of commonly used medications with sedative effects leading up to and after nursing home admission using data from 94 Danish nursing homes between 2015 and 2017.

RESULTS: We identified 5179 residents (median age 84 years, 63% female) and described monthly incidence and total use of benzodiazepines (BZDs), Z drugs, mirtazapine/mianserin, quetiapine, promethazine, and melatonin. The proportion of unique users of sedating medications was similar before and after admission (42% before vs. 40% after) despite an increase in total use after admission. The overall incidence of sedating medications peaked in the 6 months before and 6 months after admission (peaking at 4.6 per 100 person-months 1 month after admission). The most commonly initiated medications were mirtazapine/mianserin, followed by BZDs and Z drugs. Total use of sedating medications increased leading up to admission (peaking at 1001 defined daily doses per 100 residents per month 1 month after admission) and decreased gradually after admission.

CONCLUSIONS: Sedative medication initiation increases sharply leading up to admission in Danish nursing homes. Mirtazapine/mianserin is a commonly used agent in nursing homes, despite limited evidence on benefits and harms. Efforts to promote rational use of these medications in nursing homes remain warranted.

© 2021 John Wiley & Sons Ltd.

Keywords: drug utilization; hypnotics and sedatives; nursing homes; polypharmacy

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