Use of Central Nervous System (CNS) Medicines in Aged Care Homes: A Systematic Review and Meta-Analysis

Syed Shahzad Hasan, Syed Tabish Razi Zaidi, Jorabar Nirwan, Muhammad Usman Ghori, Farideh Javid, Keivan Ahmadi, Zaheer-Ud-Din Babar

Research output: Contribution to journalArticle

Abstract

Background: Both old age and institutionalization in aged care homes come with a significant risk of developing several long-term mental and neurological disorders, but there has been no definitive meta-analysis of data from studies to determine the pooled estimate of central nervous system (CNS) medicines use in aged care homes. We conducted this systematic review to summarize the use of
CNS drugs among aged care home residents. Methods: MEDLINE, EMBASE, CINAHL, Scopus, and International Pharmaceutical Abstracts (IPA) databases were searched (between 1 January 2000 and 31 December 2018) to identify population-based studies that reported the use of CNS medicines in aged care homes. Pooled proportions (with 95% confidence interval), according to study location were calculated. Results: A total of 89 studies reported the use of CNS medicines use in aged care. The pooled estimate of CNS drug use varied according to country (from 20.3% in Ireland to 49.0% in Belgium) and region (from 31.7% in North America to 42.5% in Scandinavia). The overall pooled
estimate of psychotropic medicines use was highest in Europe (72.2%, 95% CI, 67.1–77.1%) and lowest in the ANZ region (56.9%, 95% CI, 52.2–61.4%). The pooled estimate of benzodiazepines use varied widely, from 18.9% in North America to 44.8% in Europe. The pooled estimate of antidepressant use from 47 studies was 38.3% (95% CI 35.1% to 41.6%), with the highest proportion in North America (44.9%, 95% CI, 35.3–54.5%). Conclusion: The overall use of CNS drugs varied among countries, with studies from Australia New Zealand reporting the lowest use of CNS drugs. The criteria for prescribing CNS drugs in clinical practice should be evidence-based. The criteria should be used not to prohibit the use of the listed medications but to support the clinical judgement as well as
patient safety
LanguageEnglish
Number of pages17
JournalJournal of Clinical Medicine
Volume8
Issue number9
DOIs
Publication statusPublished - 23 Aug 2019

Fingerprint

Central Nervous System Agents
Homes for the Aged
Home Care Services
Systems Analysis
Meta-Analysis
Central Nervous System
North America
Pharmaceutical Databases
Scandinavian and Nordic Countries
Institutionalization
Belgium
Nervous System Diseases
Benzodiazepines
New Zealand
Ireland
Mental Disorders
MEDLINE
Antidepressive Agents
Confidence Intervals
Safety

Cite this

@article{f19ac11d725f44c39136ee1acec125d7,
title = "Use of Central Nervous System (CNS) Medicines in Aged Care Homes: A Systematic Review and Meta-Analysis",
abstract = "Background: Both old age and institutionalization in aged care homes come with a significant risk of developing several long-term mental and neurological disorders, but there has been no definitive meta-analysis of data from studies to determine the pooled estimate of central nervous system (CNS) medicines use in aged care homes. We conducted this systematic review to summarize the use ofCNS drugs among aged care home residents. Methods: MEDLINE, EMBASE, CINAHL, Scopus, and International Pharmaceutical Abstracts (IPA) databases were searched (between 1 January 2000 and 31 December 2018) to identify population-based studies that reported the use of CNS medicines in aged care homes. Pooled proportions (with 95{\%} confidence interval), according to study location were calculated. Results: A total of 89 studies reported the use of CNS medicines use in aged care. The pooled estimate of CNS drug use varied according to country (from 20.3{\%} in Ireland to 49.0{\%} in Belgium) and region (from 31.7{\%} in North America to 42.5{\%} in Scandinavia). The overall pooledestimate of psychotropic medicines use was highest in Europe (72.2{\%}, 95{\%} CI, 67.1–77.1{\%}) and lowest in the ANZ region (56.9{\%}, 95{\%} CI, 52.2–61.4{\%}). The pooled estimate of benzodiazepines use varied widely, from 18.9{\%} in North America to 44.8{\%} in Europe. The pooled estimate of antidepressant use from 47 studies was 38.3{\%} (95{\%} CI 35.1{\%} to 41.6{\%}), with the highest proportion in North America (44.9{\%}, 95{\%} CI, 35.3–54.5{\%}). Conclusion: The overall use of CNS drugs varied among countries, with studies from Australia New Zealand reporting the lowest use of CNS drugs. The criteria for prescribing CNS drugs in clinical practice should be evidence-based. The criteria should be used not to prohibit the use of the listed medications but to support the clinical judgement as well aspatient safety",
keywords = "aged care homes, antipsychotics, Antidepressants, Antiepileptics, antiparkinsons, Benzodiazepines, Central nervous system, psychotropics",
author = "Hasan, {Syed Shahzad} and Zaidi, {Syed Tabish Razi} and Jorabar Nirwan and Ghori, {Muhammad Usman} and Farideh Javid and Keivan Ahmadi and Zaheer-Ud-Din Babar",
year = "2019",
month = "8",
day = "23",
doi = "10.3390/jcm8091292",
language = "English",
volume = "8",
journal = "Journal of Clinical Medicine",
issn = "2077-0383",
publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",
number = "9",

}

Use of Central Nervous System (CNS) Medicines in Aged Care Homes : A Systematic Review and Meta-Analysis. / Hasan, Syed Shahzad; Zaidi, Syed Tabish Razi; Nirwan, Jorabar; Ghori, Muhammad Usman ; Javid, Farideh; Ahmadi, Keivan; Babar, Zaheer-Ud-Din.

In: Journal of Clinical Medicine, Vol. 8, No. 9, 23.08.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Use of Central Nervous System (CNS) Medicines in Aged Care Homes

T2 - Journal of Clinical Medicine

AU - Hasan, Syed Shahzad

AU - Zaidi, Syed Tabish Razi

AU - Nirwan, Jorabar

AU - Ghori, Muhammad Usman

AU - Javid, Farideh

AU - Ahmadi, Keivan

AU - Babar, Zaheer-Ud-Din

PY - 2019/8/23

Y1 - 2019/8/23

N2 - Background: Both old age and institutionalization in aged care homes come with a significant risk of developing several long-term mental and neurological disorders, but there has been no definitive meta-analysis of data from studies to determine the pooled estimate of central nervous system (CNS) medicines use in aged care homes. We conducted this systematic review to summarize the use ofCNS drugs among aged care home residents. Methods: MEDLINE, EMBASE, CINAHL, Scopus, and International Pharmaceutical Abstracts (IPA) databases were searched (between 1 January 2000 and 31 December 2018) to identify population-based studies that reported the use of CNS medicines in aged care homes. Pooled proportions (with 95% confidence interval), according to study location were calculated. Results: A total of 89 studies reported the use of CNS medicines use in aged care. The pooled estimate of CNS drug use varied according to country (from 20.3% in Ireland to 49.0% in Belgium) and region (from 31.7% in North America to 42.5% in Scandinavia). The overall pooledestimate of psychotropic medicines use was highest in Europe (72.2%, 95% CI, 67.1–77.1%) and lowest in the ANZ region (56.9%, 95% CI, 52.2–61.4%). The pooled estimate of benzodiazepines use varied widely, from 18.9% in North America to 44.8% in Europe. The pooled estimate of antidepressant use from 47 studies was 38.3% (95% CI 35.1% to 41.6%), with the highest proportion in North America (44.9%, 95% CI, 35.3–54.5%). Conclusion: The overall use of CNS drugs varied among countries, with studies from Australia New Zealand reporting the lowest use of CNS drugs. The criteria for prescribing CNS drugs in clinical practice should be evidence-based. The criteria should be used not to prohibit the use of the listed medications but to support the clinical judgement as well aspatient safety

AB - Background: Both old age and institutionalization in aged care homes come with a significant risk of developing several long-term mental and neurological disorders, but there has been no definitive meta-analysis of data from studies to determine the pooled estimate of central nervous system (CNS) medicines use in aged care homes. We conducted this systematic review to summarize the use ofCNS drugs among aged care home residents. Methods: MEDLINE, EMBASE, CINAHL, Scopus, and International Pharmaceutical Abstracts (IPA) databases were searched (between 1 January 2000 and 31 December 2018) to identify population-based studies that reported the use of CNS medicines in aged care homes. Pooled proportions (with 95% confidence interval), according to study location were calculated. Results: A total of 89 studies reported the use of CNS medicines use in aged care. The pooled estimate of CNS drug use varied according to country (from 20.3% in Ireland to 49.0% in Belgium) and region (from 31.7% in North America to 42.5% in Scandinavia). The overall pooledestimate of psychotropic medicines use was highest in Europe (72.2%, 95% CI, 67.1–77.1%) and lowest in the ANZ region (56.9%, 95% CI, 52.2–61.4%). The pooled estimate of benzodiazepines use varied widely, from 18.9% in North America to 44.8% in Europe. The pooled estimate of antidepressant use from 47 studies was 38.3% (95% CI 35.1% to 41.6%), with the highest proportion in North America (44.9%, 95% CI, 35.3–54.5%). Conclusion: The overall use of CNS drugs varied among countries, with studies from Australia New Zealand reporting the lowest use of CNS drugs. The criteria for prescribing CNS drugs in clinical practice should be evidence-based. The criteria should be used not to prohibit the use of the listed medications but to support the clinical judgement as well aspatient safety

KW - aged care homes

KW - antipsychotics

KW - Antidepressants

KW - Antiepileptics

KW - antiparkinsons

KW - Benzodiazepines

KW - Central nervous system

KW - psychotropics

U2 - 10.3390/jcm8091292

DO - 10.3390/jcm8091292

M3 - Article

VL - 8

JO - Journal of Clinical Medicine

JF - Journal of Clinical Medicine

SN - 2077-0383

IS - 9

ER -