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.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Smeets CH,Smalbrugge M,Zuidema SU,Derksen E,de Vries E,van der Spek K,Koopmans RT,Gerritsen DLdoi
10.1016/j.jamda.2014.08.016subject
Has Abstractpub_date
2014-01-01 00:00:00pages
835-40issue
11eissn
1525-8610issn
1538-9375pii
S1525-8610(14)00549-0journal_volume
15pub_type
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