During the COVID-19 pandemic, the provision of quality care for behavioral and psychological symptoms in older adults with dementia may have been impeded due to physical distancing and infection control measures. Of particular concern is whether psychotropic medication use has increased despite its limited efficacy and adverse effects. This systematic review described the trajectory of psychotropic use for older adults with dementia across various settings, from community living to healthcare settings during the pandemic. Also, psychotropic use was explored in relation to patients, caregivers, and environment-related factors along with the occurrence of the pandemic. We conducted a comprehensive search across five databases: Embase, PubMed, PsycINFO, CINAHL, and Cochrane Library. Methodological quality was assessed using Joanna Briggs Institute Critical Appraisal tools. A random-effects model was used to estimate the pooled risk ratios (RRs) of psychotropic use in older adults with dementia, comparing the pandemic period to the pre-pandemic period. Subgroup analyses based on the class of psychotropics and sensitivity analyses also were conducted. A funnel plot and Egger’s regression test were used to detect potential publication bias. Of the 3,123 screened articles, 15 studies were included in this systematic review, with 10 of them being part of the meta-analysis. Our meta-analysis yielded an RR of 1.16 (95% CI = 1.05–1.26) for overall psychotropic medication use. Further subgroup analysis based on the type of psychotropic medication revealed a significantly greater prevalence in the use of antipsychotics (RR = 1.19, 95% CI = 1.08–1.30). However, no significant differences were observed in the use of anxiolytics and/or hypnotics (including benzodiazepines), antidepressants, and mood stabilizers. Among psychotropics, some studies on antipsychotic use additionally explored patients, caregivers, and environmental-related factors during the pandemic. The review indicates a higher risk of psychotropic use, especially antipsychotics, during the pandemic. Nonetheless, underlying reasons for the increased psychotropic use are not fully available from the reviewed studies. Therefore, further research is needed to identify the factors driving psychotropic use during the pandemic and facilitate the development of quality improvement interventions that can be implemented to minimize inappropriate psychotropic prescribing in future pandemics.

Background/Objectives: There is a relative lack of specific research on registered nurse (RN) staffing in long-term care hospitals in the Republic of Korea. This study investigated the association between RN staffing levels and inpatient outcomes in long-term care hospitals in the Republic of Korea. Methods: Nationwide data of long-term care hospitals from the Health Insurance Review and Assessment Services website were used to analyze the association between registered nurse staffing levels and 7 inpatient outcome indicators. Results: The results indicated that in long-term care hospitals with higher RN staffing levels, there was an improvement in moderate-to-severe pain, activities of daily living enhancement, lower prevalence of indwelling catheters, reduction in the incidence of pressure ulcers, improvement in existing pressure ulcers, and increased rate of return to the community. Similar results were observed in analyses conducted according to disease classification groups. Conclusions: These findings suggest that increasing RN staffing levels can enhance patient safety and improve treatment outcomes. Furthermore, this study provided important foundational data for developing policies to optimize RN staffing in long-term care hospitals in the Republic of Korea.