Hostname: page-component-77c89778f8-gq7q9 Total loading time: 0 Render date: 2024-07-23T09:16:40.510Z Has data issue: false hasContentIssue false
  • English
  • Français

Cross-National Comparisons of Antidepressant Use Among Institutionalized Older Persons Based on the Minimum Data Set (MDS)

Published online by Cambridge University Press:  29 November 2010

John P. Hirdes ,
Naoki Ikegami ,
Pálmi V. Jónsson ,
Eva Topinková ,
Colleen J. Maxwell  and
Keita Yamauchi
John P. Hirdes
Affiliation:
University of Waterloo and Providence Centre
Naoki Ikegami
Affiliation:
Keio University
Pálmi V. Jónsson
Affiliation:
University of Iceland
Eva Topinková
Affiliation:
Charles University, Czech Republic
Colleen J. Maxwell
Affiliation:
University of Calgary
Keita Yamauchi
Affiliation:
Keio University, Japan
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Antidepressant use was examined with samples from long-term care facilities in Toronto (Canada), Sapporo and Naie (Japan), Reykjavik (Iceland) and Prague (Czech Republic). Only in Iceland did the majority of residents with depression receive an antidepressant. Rates of depression and antidepressant use were uniformly low in Japan, and there was a great discrepancy between diagnosed depression and behavioural signs of depression in the Czech Republic. In all countries, about half the recipients of antidepressants have no clear indication of depression present. For some countries, antidepressant use was lower among residents who were female, older and more disabled. Depression is clearly under-diagnosed in the Czech Republic, but low rates of depression in Japan are somewhat more difficult to interpret. Given the widespread consensus that depression is under-detected and under treated, these results suggest that responses to depression could be improved through instruments like the MDS.

Résumé

RÉSUMÉ

On a examiné l'usage des antidépresseurs dans des échantillons provenant d'établissements de soins de longue durée de Toronto (Canada), Sapporo et Naie (Japon), Reykjavik (Islande) et Prague (République tchéque). C'est seulement en Islande que la majorité des résidents souffrant de dépression recevaient des antidépresseurs. Le taux de dépression et l'usage des antidépresseurs sont généralement faibles au Japon. On a constaté un écart important entre le diagnostic de dépression et le comportement dépressif en République tchèque. Dans tous les pays examinés, environ la moitié des utilisateurs d'antidépresseurs ne présentent pas de symptômes évidents de dépression. Dans certains pays, l'usage des antidépresseurs était moins élevé chez les résidentes, chez les aîné(e)s plus âgés ou plus handicapés. La dépression est clairement sous-diagnostiqué en République tchèque mais les faibles taux de dépression au Japon sont plus difficiles à interpréter. Étant donné l'opinion largement répandue voulant que la dépressione passe souvent inaperçue et soit done mal soignée, les résultats de l'étude laissent entendre que l'on pourrait améliorer les mesures prises dans les cas de dépression grâce à des outils comme le MDS.

Keywords

DepressionMental HealthLong-Term CareDépressionsanté mentalesoins de longue durée
Type
Research Article
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 19 , supplement S2 , Fall/Automne 2000 , pp. 18 - 37
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
Copyright © Canadian Association on Gerontology 2000

Footnotes

*

Dr. Hirdes' involvement in this project was supported through the Seniors Independence Program, Health Canada and by the Providence Centre Foundation. Dr. Topinková's work is supported under grant number IGA MZ 2084-3.

1

Department of Health Studies & Gerontology, University of Waterloo, Waterloo, ON, N2L 3G1, (hirdes@healthy.uwaterloo.ca)

References

Abrams, R.C., Teresi, J.A., & Butin, D.N. (1992). Depression in nursing home residents. Clinics in Geriatric Medicine, 8, 309–322.10.1016/S0749-0690(18)30482-8CrossRefGoogle ScholarPubMed
Ames, D. (1991). Epidemiological studies of depression among elderly in residential and nursing homes. International Journal of Geriatric Psychiatry, 6, 347–354.10.1002/gps.930060604CrossRefGoogle Scholar
Bernabei, R., Gambassi, G., Lapane, K., Landi, F., Gatsonis, C., Dunlop, F., Lipsitz, L., Steel, K., & Mor, V. (1998). Management of pain in elderly patients with cancer. Journal of the American Medical Association, 279, 1877–1882.CrossRefGoogle ScholarPubMed
Burrows, A.B., Satlin, A., Salzman, C., Nobel, K., & Lipsitz, L.A.(1995). Depression in a long-term care facility: Clinical features and discordance between nursing assessment and patient interviews. Journal of the American Medical Association, 267, 1783–1787.Google Scholar
Carpenter, G.I., Challis, D., Hirdes, J.P., Ljunggren, G., & Bernabei, R. (1999). Care of older people: A comparison of systems in North America, Europe and Japan. London UK: Farrand Press.Google Scholar
Conn, D.K., & Goldman, Z. (1992). Patterns of use of antidepressants in long-term care facilities for the elderly. Journal of Geriatric Psychiatry and Neurology, 5, 228–232.10.1177/002383099200500408CrossRefGoogle Scholar
Fogel, B. (1997). Psychotropic drugs. In Morris, J.N., Lipsitz, L.A., Murphy, K., & Taylor, P. Belleville (Eds.), Quality care in the nursing home. Toronto: Mosby Lifeline.Google Scholar
Fries, B.E., Schneider, D.P., Foley, J.W., Gavazzi, M., Burke, R., & Cornelius, É(1994). Refining a case-mix measure for nursing homes: Resource Utilization Groups (RUG-III). Medical Care, 32, 668–685.10.1097/00005650-199407000-00002CrossRefGoogle Scholar
Fujihara, S. (1995). Epidemiologic study on depression in a community population: Its prevalence and precipitating factors, Keio Igaku, 72, 511–528 (In Japanese).Google Scholar
Gelenberg, A. (1999). Depression is still underrecognized and undertreated. Archives of Internal Medicine, 159, 1657.CrossRefGoogle ScholarPubMed
Hawes, C., Morris, J.N., Philips, C.D., Mor, V., & Fries, B.E. (1995). Reliability estimates for the Minimum Data Set for nursing home resident assessment and care screening (MDS). The Gerontologist, 35, 172–178.10.1093/geront/35.2.172CrossRefGoogle Scholar
Heston, L.L., Garrard, J., Makris, L., Kane, R.L., Cooper, S., Dunham, T., & Zelterman, D. (1992). Inadequate treatment of depressed nursing home elderly. Journal of the American Geriatrics Society, 40, 1117–1122.10.1111/j.1532-5415.1992.tb01800.xCrossRefGoogle ScholarPubMed
Hirdes, J.P., Mitchell, L., Ljunggren, G., & Schroll, M. (1999). International and regional variations in restraint use: Implications for selecting benchmarks. Canadian Journal on Quality in Health Care, 15(2), 19–23.Google Scholar
Hirschfeld, R.M.A., Keller, M.B., Panico, S., Arons, B.S., Barlow, D., Davidoff, F., Endicott, J., Froom, J., Goldstein, M., Gorman, J.M., Marek, R.G., Maurer, T.A., Meyer, R., Phillips, K., Ross, J., Schwenk, T.L., Sharfstein, S.S., Thase, M., & Wyatt, R.J. (1997). The national depressive and manic-depressive association consensus statement on the undertreatment of depression. Journal of the American Medical Association, 277, 333–340.CrossRefGoogle ScholarPubMed
Ikegami, N. (1995). The MDS care plan - How it developed and its future, Byouin, 54, 274–280 (In Japanese).Google Scholar
Karon, S.L., & Zimmerman, D.R. (1996). Using indicators to structure quality improvement initiatives in long-term care. Quality Management in Health Care, 4, 54–66.CrossRefGoogle ScholarPubMed
Lyness, J.M., Bruce, M.L., Koenig, H.G., Parmelee, P.A., Schulz, R., Lawton, M.P., & Reynolds, C.F. (1996). Depression and medical illness in late life: Report of a symposium. Journal of the American Geriatrics Society, 44, 198–203.CrossRefGoogle ScholarPubMed
Morris, J.N., Hawes, C., Fries, B.E., Phillips, C., Mor, V., Katz, S., Murphy, K., Drugovich, M.L., & Friedlob, A.S. (1990). Designing the national resident assessment instrument for nursing homes. The Gerontologist, 30(3), 293–307.CrossRefGoogle ScholarPubMed
Morris, J.N., Nonemaker, S., Murphy, K., Hawes, C., Fries, B.E., Mor, V., & Phillips, C. (1997). Commitment to change: Revision of HCFA's RAI. Journal of the American Geriatrics Society, 45, 1011–1016.CrossRefGoogle ScholarPubMed
NIH Consensus Development Panel on Depression in Late Life. (1992). Diagnosis and treatment of depression in late life. Journal of the American Medical Association, 268, 1018–1024.CrossRefGoogle Scholar
Nolan, L., & O'Malley, K. (1992). Adverse effects of antidepressants in the elderly. Drugs and Aging, 2, 450–458.CrossRefGoogle ScholarPubMed
Phillips, C., Zimmerman, D., Bernabei, R., Jonsson, P. (1997). Using the Resident Assessment Instrument for quality enhancement in nursing homes. Age and Ageing, 26 (suppl. 2), 77–82.CrossRefGoogle ScholarPubMed
Rovner, B.W., German, P.S., Brant, L.J., Clark, R., Burton, L., & Folstein, M.F. (1991). Depression and mortality in nursing homes. Journal of the American Medical Association, 265, 993–996.CrossRefGoogle ScholarPubMed
Salzman, C. (1992). Clinical geriatric psychopharmacology (2nd Ed.) Baltimore MD: Williams and Wilkings.Google Scholar
Sgadari, A., Morris, J.N., Fries, B.E., Ljunggren, G., Jónsson, P., DuPasquier, J.N., & Schroll, M. (1997). Efforts to establish the reliability of the RAI. Age and Ageing, 26 (suppl. 2), 27–30.CrossRefGoogle Scholar
Small, G.W., Birkett, M., Meyers, B.S., Koran, L.M., Bystritsky, A., & Nemeroff, C.B. (1996). Impact of physical illness on quality of life and antidepressant response in geriatric major depression. Journal of the American Geriatrics Society, 44, 1220–1225.CrossRefGoogle ScholarPubMed
Topinková, E., & Neuwirth, J. (1997). Depressive syndrome in geriatric patients in long-term institutional care. Ceska Psychiatrie, 93, 181–188 (In Czech).Google Scholar
Vinar, O. (1996). Pharmacotherapy of depression. Farmakoterapie depresí Prakt Lékar, 76, 349–352 (In Czech).Google Scholar
Weissman, M.M., Bland, R.C., Canino, G.J., Faravelli, C., Greenwald, S., Hwu, H.G., Joyce, P.R., Karam, E.G., Lee, C.K., Lellouch, J., Lepine, J.P., Newman, S.C., Rubio-Stepec, M., Wells, J.E., Wickramaratne, P.J., Wittchen, H., & Yeh, E.K. (1996). Cross-national and epidemiology of major depression an bipolar disorder. Journal of the American Medical Association, 276, 293–299.CrossRefGoogle ScholarPubMed
Weissmann, M.M. (1984). The epidemiology of depression: An update on sex differences in rates. Journal of Affective Disorders, 7, 179–188.CrossRefGoogle Scholar
Zimmerman, D.R., Karon, S.L., Arling, G., Ryther Clark, B., Collins, T., Ross, R., & Sainfort, F. (1995). Development and testing of nursing home quality indicators. Health Care Financing Review, 16, 107–127.Google ScholarPubMed