Use of physical restraints and antipsychotic medications in nursing homes

A cross-national study

Zhanlian Feng, John P. Hirdes, Trevor F. Smith, Harriet Finne-Soveri, Iris Chi, Jean Noel Du Pasquier, Ruedi Gilgen, Naoki Ikegami, Vincent Mor

Research output: Contribution to journalArticle

89 Citations (Scopus)

Abstract

Objectives: This study compares inter- and intra-country differences in the prevalence of physical restraints and antipsychotic medications in nursing homes, and examines aggregated resident conditions and organizational characteristics correlated with these treatments. Methods: Population-based, cross-sectional data were collected using a standardized Resident Assessment Instrument (RAI) from 14,504 long-term care facilities providing nursing home level services in five countries participating in the interRAI consortium, including Canada, Finland, Hong Kong (Special Administrative Region, China), Switzerland, and the United States. Facility-level prevalence rates of physical restraints and antipsychotic use were examined both between and within the study countries. Results: The prevalence of physical restraint use varied more than five-fold across the study countries, from an average 6% in Switzerland, 9% in the US, 20% in Hong Kong, 28% in Finland, and over 31% in Canada. The prevalence of antipsychotic use ranged from 11% in Hong Kong, between 26-27% in Canada and the US, 34% in Switzerland, and nearly 38% in Finland. Within each country, substantial variations existed across facilities in both physical restraint and antipsychotic use rates. In all countries, neither facility case mix nor organizational characteristics were particularly predictive of the prevalence of either treatment. Conclusions: There exists large, unexplained variability in the prevalence of physical restraint and antipsychotic use in nursing home facilities both between and within countries. Since restraints and antipsychotics are associated with adverse outcomes, it is important to understand the idiosyncratic factors specific to each country that contribute to variation in use rates.

Original languageEnglish
Pages (from-to)1110-1118
Number of pages9
JournalInternational Journal of Geriatric Psychiatry
Volume24
Issue number10
DOIs
Publication statusPublished - 2009 Oct

Fingerprint

Physical Restraint
Nursing Homes
Antipsychotic Agents
Hong Kong
Finland
Switzerland
Canada
Diagnosis-Related Groups
Long-Term Care
China
Therapeutics
Population

Keywords

  • Antipsychotics
  • Cross-national study
  • Minimum Data Set (MDS)
  • Nursing homes
  • Physical restraints
  • Resident Assessment Instrument (RAI)

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

Feng, Z., Hirdes, J. P., Smith, T. F., Finne-Soveri, H., Chi, I., Du Pasquier, J. N., ... Mor, V. (2009). Use of physical restraints and antipsychotic medications in nursing homes: A cross-national study. International Journal of Geriatric Psychiatry, 24(10), 1110-1118. https://doi.org/10.1002/gps.2232

Use of physical restraints and antipsychotic medications in nursing homes : A cross-national study. / Feng, Zhanlian; Hirdes, John P.; Smith, Trevor F.; Finne-Soveri, Harriet; Chi, Iris; Du Pasquier, Jean Noel; Gilgen, Ruedi; Ikegami, Naoki; Mor, Vincent.

In: International Journal of Geriatric Psychiatry, Vol. 24, No. 10, 10.2009, p. 1110-1118.

Research output: Contribution to journalArticle

Feng, Z, Hirdes, JP, Smith, TF, Finne-Soveri, H, Chi, I, Du Pasquier, JN, Gilgen, R, Ikegami, N & Mor, V 2009, 'Use of physical restraints and antipsychotic medications in nursing homes: A cross-national study', International Journal of Geriatric Psychiatry, vol. 24, no. 10, pp. 1110-1118. https://doi.org/10.1002/gps.2232
Feng, Zhanlian ; Hirdes, John P. ; Smith, Trevor F. ; Finne-Soveri, Harriet ; Chi, Iris ; Du Pasquier, Jean Noel ; Gilgen, Ruedi ; Ikegami, Naoki ; Mor, Vincent. / Use of physical restraints and antipsychotic medications in nursing homes : A cross-national study. In: International Journal of Geriatric Psychiatry. 2009 ; Vol. 24, No. 10. pp. 1110-1118.
@article{8b539d4353234b239024dc6862d84375,
title = "Use of physical restraints and antipsychotic medications in nursing homes: A cross-national study",
abstract = "Objectives: This study compares inter- and intra-country differences in the prevalence of physical restraints and antipsychotic medications in nursing homes, and examines aggregated resident conditions and organizational characteristics correlated with these treatments. Methods: Population-based, cross-sectional data were collected using a standardized Resident Assessment Instrument (RAI) from 14,504 long-term care facilities providing nursing home level services in five countries participating in the interRAI consortium, including Canada, Finland, Hong Kong (Special Administrative Region, China), Switzerland, and the United States. Facility-level prevalence rates of physical restraints and antipsychotic use were examined both between and within the study countries. Results: The prevalence of physical restraint use varied more than five-fold across the study countries, from an average 6{\%} in Switzerland, 9{\%} in the US, 20{\%} in Hong Kong, 28{\%} in Finland, and over 31{\%} in Canada. The prevalence of antipsychotic use ranged from 11{\%} in Hong Kong, between 26-27{\%} in Canada and the US, 34{\%} in Switzerland, and nearly 38{\%} in Finland. Within each country, substantial variations existed across facilities in both physical restraint and antipsychotic use rates. In all countries, neither facility case mix nor organizational characteristics were particularly predictive of the prevalence of either treatment. Conclusions: There exists large, unexplained variability in the prevalence of physical restraint and antipsychotic use in nursing home facilities both between and within countries. Since restraints and antipsychotics are associated with adverse outcomes, it is important to understand the idiosyncratic factors specific to each country that contribute to variation in use rates.",
keywords = "Antipsychotics, Cross-national study, Minimum Data Set (MDS), Nursing homes, Physical restraints, Resident Assessment Instrument (RAI)",
author = "Zhanlian Feng and Hirdes, {John P.} and Smith, {Trevor F.} and Harriet Finne-Soveri and Iris Chi and {Du Pasquier}, {Jean Noel} and Ruedi Gilgen and Naoki Ikegami and Vincent Mor",
year = "2009",
month = "10",
doi = "10.1002/gps.2232",
language = "English",
volume = "24",
pages = "1110--1118",
journal = "International Journal of Geriatric Psychiatry",
issn = "0885-6230",
publisher = "John Wiley and Sons Ltd",
number = "10",

}

TY - JOUR

T1 - Use of physical restraints and antipsychotic medications in nursing homes

T2 - A cross-national study

AU - Feng, Zhanlian

AU - Hirdes, John P.

AU - Smith, Trevor F.

AU - Finne-Soveri, Harriet

AU - Chi, Iris

AU - Du Pasquier, Jean Noel

AU - Gilgen, Ruedi

AU - Ikegami, Naoki

AU - Mor, Vincent

PY - 2009/10

Y1 - 2009/10

N2 - Objectives: This study compares inter- and intra-country differences in the prevalence of physical restraints and antipsychotic medications in nursing homes, and examines aggregated resident conditions and organizational characteristics correlated with these treatments. Methods: Population-based, cross-sectional data were collected using a standardized Resident Assessment Instrument (RAI) from 14,504 long-term care facilities providing nursing home level services in five countries participating in the interRAI consortium, including Canada, Finland, Hong Kong (Special Administrative Region, China), Switzerland, and the United States. Facility-level prevalence rates of physical restraints and antipsychotic use were examined both between and within the study countries. Results: The prevalence of physical restraint use varied more than five-fold across the study countries, from an average 6% in Switzerland, 9% in the US, 20% in Hong Kong, 28% in Finland, and over 31% in Canada. The prevalence of antipsychotic use ranged from 11% in Hong Kong, between 26-27% in Canada and the US, 34% in Switzerland, and nearly 38% in Finland. Within each country, substantial variations existed across facilities in both physical restraint and antipsychotic use rates. In all countries, neither facility case mix nor organizational characteristics were particularly predictive of the prevalence of either treatment. Conclusions: There exists large, unexplained variability in the prevalence of physical restraint and antipsychotic use in nursing home facilities both between and within countries. Since restraints and antipsychotics are associated with adverse outcomes, it is important to understand the idiosyncratic factors specific to each country that contribute to variation in use rates.

AB - Objectives: This study compares inter- and intra-country differences in the prevalence of physical restraints and antipsychotic medications in nursing homes, and examines aggregated resident conditions and organizational characteristics correlated with these treatments. Methods: Population-based, cross-sectional data were collected using a standardized Resident Assessment Instrument (RAI) from 14,504 long-term care facilities providing nursing home level services in five countries participating in the interRAI consortium, including Canada, Finland, Hong Kong (Special Administrative Region, China), Switzerland, and the United States. Facility-level prevalence rates of physical restraints and antipsychotic use were examined both between and within the study countries. Results: The prevalence of physical restraint use varied more than five-fold across the study countries, from an average 6% in Switzerland, 9% in the US, 20% in Hong Kong, 28% in Finland, and over 31% in Canada. The prevalence of antipsychotic use ranged from 11% in Hong Kong, between 26-27% in Canada and the US, 34% in Switzerland, and nearly 38% in Finland. Within each country, substantial variations existed across facilities in both physical restraint and antipsychotic use rates. In all countries, neither facility case mix nor organizational characteristics were particularly predictive of the prevalence of either treatment. Conclusions: There exists large, unexplained variability in the prevalence of physical restraint and antipsychotic use in nursing home facilities both between and within countries. Since restraints and antipsychotics are associated with adverse outcomes, it is important to understand the idiosyncratic factors specific to each country that contribute to variation in use rates.

KW - Antipsychotics

KW - Cross-national study

KW - Minimum Data Set (MDS)

KW - Nursing homes

KW - Physical restraints

KW - Resident Assessment Instrument (RAI)

UR - http://www.scopus.com/inward/record.url?scp=67949122109&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67949122109&partnerID=8YFLogxK

U2 - 10.1002/gps.2232

DO - 10.1002/gps.2232

M3 - Article

VL - 24

SP - 1110

EP - 1118

JO - International Journal of Geriatric Psychiatry

JF - International Journal of Geriatric Psychiatry

SN - 0885-6230

IS - 10

ER -