IMPACT OF COVID-19 ON PSYCHOTROPIC USE IN THE ELDERLY
Background: Nursing homes have been especially impacted by COVID-19 given disproportionate numbers of residents with cognitive impairment. Additionally, pandemic safety measures have increased staff burden and decreased availability of non-pharmacological interventions. Although psychotropic medications are highly regulated and seen as therapy of last resort, a gap exists in our knowledge of whether our use of psychotropic medication in nursing homes has increased during the pandemic.
Objective: To review existing literature on COVID and older persons and summarize the impact on psychological health and psychotropic usage in preparation for a Kalamazoo study.
Methods: We performed a PubMed search with the terms "pandemic OR COVID" AND "elderly OR aging OR dementia" generating 2,947 results. Inclusion criteria required at least 2 of 5 of the aforementioned terms and specific mention of psychotropic drug use.
Results: 14 articles met inclusion criteria, and an additional 14 were found by referencing bibliographies. 13 of these papers demonstrated the vulnerability of elderly patients to pandemic-related psychiatric morbidity. A national survey study in Italy showed 5.7% of nursing homes reported increases in psychotropic drug use. A population study in Ontario demonstrated absolute increases in use of several antipsychotics. A community study in Argentina found a 20.2% increase in new antipsychotics and 15.1% increase in benzodiazepines.
Discussion: Our literature review suggests an increase in psychotropic prescription amongst the elderly during the pandemic, coinciding with evidence that COVID-19 has introduced widespread mental health challenges. Our findings warrant further research into changes in psychotropic usage in Kalamazoo.