Psychotropic use for behavioral and psychological symptoms of dementia during the COVID-19 pandemic: a systematic review and meta-analysis DOI Creative Commons
Jung Min Yoon, Eunjin Kim, Alison M. Trinkoff

et al.

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

Psychotropic, Anticonvulsant, and Opioid Use in Assisted Living Residents Before and During the COVID-19 Pandemic DOI
Colleen J. Maxwell,

Hana Dampf,

Wajd Alkabbani

et al.

Journal of the American Medical Directors Association, Journal Year: 2023, Volume and Issue: 25(1), P. 121 - 129

Published: Oct. 17, 2023

Language: Английский

Citations

8
Comparison of hospitalization events among residents of assisted living and nursing homes during COVID-19: Do settings respond differently during public health crises? DOI Creative Commons
Colleen J. Maxwell, Eric McArthur, David B. Hogan

et al.

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

Citations

1
Association between assisted living facility context and resident pain during the COVID-19 pandemic: A repeated cross-sectional study DOI Creative Commons
Matthias Hoben, Shovana Shrestha,

Hana Dampf

et al.

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

Citations

0
Associations between specialized dementia care, COVID-19 and central nervous system medication use in assisted living: a population-based repeated cross-sectional study DOI Creative Commons
Colleen J. Maxwell,

Hana Dampf,

J. Squires

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

Citations

0
Intervention scenarios and robot capabilities for support, guidance and health monitoring for the elderly DOI Creative Commons

Saja Aldawsari,

Yi‐Ping Phoebe Chen

Computer Science Review, Journal Year: 2024, Volume and Issue: 54, P. 100687 - 100687

Published: Oct. 22, 2024

Language: Английский

Citations

0
Psychotropic use for behavioral and psychological symptoms of dementia during the COVID-19 pandemic: a systematic review and meta-analysis DOI Creative Commons
Jung Min Yoon, Eunjin Kim, Alison M. Trinkoff

et al.

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

Citations

0