Psychotropic, Anticonvulsant, and Opioid Use in Assisted Living Residents Before and During the COVID-19 Pandemic
Journal of the American Medical Directors Association,
Journal Year:
2023,
Volume and Issue:
25(1), P. 121 - 129
Published: Oct. 17, 2023
Language: Английский
Comparison of hospitalization events among residents of assisted living and nursing homes during COVID-19: Do settings respond differently during public health crises?
PLoS ONE,
Journal Year:
2024,
Volume and Issue:
19(7), P. e0306569 - e0306569
Published: July 12, 2024
Background
COVID-19
and
resulting
health
system
policy
decisions
led
to
significant
changes
in
healthcare
use
by
nursing
homes
(NH)
residents.
It
is
unclear
whether
outcomes
were
similarly
affected
among
older
adults
assisted
living
(AL).
This
study
compared
hospitalization
events
AL
NHs
during
pandemic
waves
1
through
4,
relative
historical
periods.
Methods
was
a
population-based,
repeated
cross-sectional
using
linked
clinical
administrative
databases
(January
2018
December
2021)
for
residents
of
all
publicly
subsidized
NH
settings
Alberta,
Canada.
Setting-specific
monthly
cohorts
derived
(starting
March
1,
2020)
comparable
(2018/2019
combined)
Monthly
rates
(per
100
person-days)
all-cause
hospitalization,
with
delayed
discharge,
death
plotted
rate
ratios
(RR)
estimated
period
(pandemic
wave
vs
comparison),
setting
(AL
NH)
period-setting
interactions,
Poisson
regression
generalized
estimating
equations,
adjusting
resident
home
characteristics.
Results
On
2020,
there
9,485
14,319
residents,
age
(mean
81
years),
sex
(>60%
female)
dementia
prevalence
(58–62%).
All-cause
declined
both
(AL:
adjusted
RR
0.60,
95%CI
0.51–0.71;
NH:
0.74,
0.64–0.85)
4
0.76,
0.66–0.88;
0.65,
0.56–0.75)
but
unlike
NHs,
not
significantly
lower
2
(and
increased
27%
NH,
January
2021).
Hospitalization
discharge
only
(during
immediately
after
1).
Both
showed
increase
2,
this
larger
persisted
longer
AL.
Conclusions
Pandemic-related
differed
wave,
suggesting
unique
factors
driving
these
response
external
stress.
Language: Английский
Association between assisted living facility context and resident pain during the COVID-19 pandemic: A repeated cross-sectional study
Research Square (Research Square),
Journal Year:
2024,
Volume and Issue:
unknown
Published: March 7, 2024
Abstract
Background
Resident
pain
has
been
a
common
quality
issue
in
congregate
care
for
older
adults,
and
COVID-19-related
public
health
restrictions
may
have
negatively
affected
resident
pain.
Most
studies
focused
on
nursing
homes
(NHs),
largely
neglecting
assisted
living
(AL).
AL
residents
are
at
similar
risk
as
NH
resident,
but
with
providing
fewer
services
staffing
resources.
Our
study
examined
whether
potentially
modifiable
home
characteristics
were
associated
during
the
first
two
waves
of
COVID-19
pandemic.
Methods
This
repeated
cross-sectional
linked
surveys,
collected
1
(March-June
2020)
2
(October
2020-February
2021)
from
key
contact,
to
administrative
Assessment
Instrument
–
Home
Care
(RAI-HC)
records
these
homes.
Surveys
assessed
preparedness
outbreaks,
availability
registered
nurse
or
practitioner,
direct
staff
shortages,
decreased
morale,
confinement
their
rooms,
supporting
video
calls
physicians,
facilitating
caregiver
involvement.
The
dependent
variable
(moderate
daily
severe
intensity)
covariates
came
RAI-HC.
Using
general
estimating
equations,
adjusted
assessments
covariates,
we
assessd
factors
Results
We
included
985
41
facilities
(wave
1),
1,134
42
2).
Pain
prevalence
[95%
confidence
interval]
non-significantly
20.6%
[18.6%-23.2%]
2019)
19.1%
[16.9%-21.6%]
2021).
Better
(odds
ratio
=
1.383
[1.025–1.866]),
rooms
(OR
1.616
[1.212–2.155]),
practitioner
0.761
[0.591–0.981]),
shortages
0.684
[0.527–0.888])
Conclusions
facility-level
Policy
management
interventions
can
must
address
such
factors,
powerful
levers
improving
care.
Language: Английский
Associations between specialized dementia care, COVID-19 and central nervous system medication use in assisted living: a population-based repeated cross-sectional study
Colleen J. Maxwell,
No information about this author
Hana Dampf,
No information about this author
J. Squires
No information about this author
et al.
BMC Geriatrics,
Journal Year:
2024,
Volume and Issue:
24(1)
Published: Aug. 14, 2024
Abstract
Background
Assisted
living
(AL)
is
an
increasingly
common
residential
setting
for
persons
with
dementia;
yet
concerns
exist
about
sub-optimal
care
of
this
population
in
AL
given
its
lower
levels
staffing
and
services.
Our
objectives
were
to
(i)
examine
associations
between
(dementia
vs.
other),
COVID-19
pandemic
waves,
prevalent
antipsychotic,
antidepressant,
anti-dementia,
benzodiazepine,
anticonvulsant
drug
use
among
residents
dementia/cognitive
impairment,
(ii)
explore
resident
home
characteristics
medication
use.
Methods
We
conducted
a
population-based,
repeated
cross-sectional
study
using
linked
clinical
health
administrative
databases
all
publicly
funded
homes
Alberta,
Canada,
examined
January
2018
-
December
2021.
The
quarterly
proportion
dispensed
was
each
period
(pandemic
comparable
historical
[2018/2019
combined])
focusing
on
four
waves
(March-May
2020,
September
2020-February
2021,
March-May
September-December
2021).
Log-binomial
GEE
models
estimated
prevalence
ratios
(PR)
periods),
other)
period-setting
interactions,
adjusting
(age,
sex)
(COVID-19
cases,
region,
ownership)
characteristics.
Results
On
March
1,
there
2,779
dementia
3,013
other
(mean
age
83,
69%
female)
impairment.
Antipsychotic
increased
during
2–4
both
settings,
but
more
pronounced
than
3
4
(e.g.,
adjusted
[adj]PR
1.20,
95%
CI
1.14–1.27
adjPR
1.09,
1.02–1.17,
interaction
p
=
0.023,
wave
3).
Both
settings
showed
statistically
significant
modest
increase
antidepressant
decrease
benzodiazepine
For
only,
gabapentinoid
several
1.32,
1.10–1.59,
Other
anti-dementia
2,
no
effects
observed.
Conclusions
persistence
the
pandemic-associated
antipsychotic
coupled
greater
raises
attendant
risks
cognitive
Language: Английский
Intervention scenarios and robot capabilities for support, guidance and health monitoring for the elderly
Saja Aldawsari,
No information about this author
Yi‐Ping Phoebe Chen
No information about this author
Computer Science Review,
Journal Year:
2024,
Volume and Issue:
54, P. 100687 - 100687
Published: Oct. 22, 2024
Language: Английский
Psychotropic use for behavioral and psychological symptoms of dementia during the COVID-19 pandemic: a systematic review and meta-analysis
BMC Geriatrics,
Journal Year:
2024,
Volume and Issue:
24(1)
Published: Nov. 21, 2024
During
the
COVID-19
pandemic,
provision
of
quality
care
for
behavioral
and
psychological
symptoms
in
older
adults
with
dementia
may
have
been
impeded
due
to
physical
distancing
infection
control
measures.
Of
particular
concern
is
whether
psychotropic
medication
use
has
increased
despite
its
limited
efficacy
adverse
effects.
This
systematic
review
described
trajectory
across
various
settings,
from
community
living
healthcare
settings
during
pandemic.
Also,
was
explored
relation
patients,
caregivers,
environment-related
factors
along
occurrence
We
conducted
a
comprehensive
search
five
databases:
Embase,
PubMed,
PsycINFO,
CINAHL,
Cochrane
Library.
Methodological
assessed
using
Joanna
Briggs
Institute
Critical
Appraisal
tools.
A
random-effects
model
used
estimate
pooled
risk
ratios
(RRs)
dementia,
comparing
pandemic
period
pre-pandemic
period.
Subgroup
analyses
based
on
class
psychotropics
sensitivity
also
were
conducted.
funnel
plot
Egger's
regression
test
detect
potential
publication
bias.
3,123
screened
articles,
15
studies
included
this
review,
10
them
being
part
meta-analysis.
Our
meta-analysis
yielded
an
RR
1.16
(95%
CI
=
1.05–1.26)
overall
use.
Further
subgroup
analysis
type
revealed
significantly
greater
prevalence
antipsychotics
(RR
1.19,
95%
1.08–1.30).
However,
no
significant
differences
observed
anxiolytics
and/or
hypnotics
(including
benzodiazepines),
antidepressants,
mood
stabilizers.
Among
psychotropics,
some
antipsychotic
additionally
environmental-related
The
indicates
higher
use,
especially
antipsychotics,
Nonetheless,
underlying
reasons
are
not
fully
available
reviewed
studies.
Therefore,
further
research
needed
identify
driving
facilitate
development
improvement
interventions
that
can
be
implemented
minimize
inappropriate
prescribing
future
pandemics.
Language: Английский