Influence of Mental Health Assessment on Prescription of Psychoactive Medication Among New Nursing Home Residents
Psychoactive Medication, nursing home residents
This article presents preliminary evidence for a novel way of promoting use of non-psychopharmacological interventions for mental health problems among nursing home (NH) residents. Mental health assessments addressing cognitive status, mood, behavior problems, typical activities, and quality of life were conducted on newly admitted NH residents, with recommendations supporting non-psychopharmacological alternatives conveyed to the NH staff. The purpose was to determine whether non-psychopharmacological recommendations based on the assessments would have a significant influence on psychoactive prescribing patterns, use of psychological interventions, number of falls, and the number of hospitalizations among NH residents. Chart reviews were conducted 1 month post-NH assessment in a non-randomized design comparing the 23 residents in four for-profit NHs who received a mental health assessment with 25 residents in one of the for-profit NHs who did not receive an assessment. A mental health assessment administered to all incoming NH residents is feasible and takes a brief amount of time to implement. One month post-assessment, those residents who received the mental health assessment were less likely to begin to be prescribed psychoactive medication and insomnia medication, and there was a trend for them to be more likely to receive mental health consultations. Findings of this pilot study suggest that the systematic provision of such an assessment/intervention may promote good quality mental health care by reducing prescriptions of psychoactive medications and by increasing broadly defined psychological interventions. This evidence-based approach could lead to reduced medical costs that more than offset the expense of the assessments, but more controlled long-term studies with better comparison groups are needed.
Molinari, V. A., Chiriboga, D. A., Branch, L. G., Greene, J., Schonfeld, L., Vongxaiburana, E., & Hyer, K. (2013). Influence of mental health assessment on prescription of psychoactive medication among new nursing home residents. Clinical Gerontologist, 36(1), 33-45. doi:10.1080/07317115.2012.731475