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.
Keywords
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Article info
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
