Changes in hypnotic usage in residential homes for the elderly: a longitudinal study.

The use of hypnotic drugs in 25 local authority homes for the elderly was recorded on a 1-day point prevalence study following a 6-mth monitoring programme involving all new admissions. From a total population of 1114 residents 390 (35%) were taking hypnotics on the night of the survey, showing a slight increase from similar surveys carried out in 1980 and 1981. The proportion of residents receiving hypnotics within each home varied from 0.0 to 61.8%. Correlation with levels of usage in the previous surveys was low, suggesting that pattern of hypnotic usage may change considerably over time within individual homes. Of the 156 residents who were admitted as permanent residents during the 6-mth period preceding the survey, 56 (35.9%) had been taking hypnotics on admission. Both the results of the drug monitoring programme and the survey show an association between hypnotic usage and source of admission: residents admitted from hospital being more likely to be taking sleeping tablets. A considerable change was found in the type of hypnotic currently prescribed with an increased preference being shown for short half-life hypnotics. A higher proportion of residents also were prescribed lower doses of hypnotics than previously, suggesting an increased awareness of the risks associated with hypnotic use in the elderly.