And it seems that this practice is not just a Norwegian phenomenon - a British study in 2000 reported that 71% of residential, nursing, and inpatient units in southeast England at least sometimes administered drugs covertly in food and beverages.

They carried out interviews with professional carers of 1362 patients in 160 regular nursing homes, and 564 patients in 90 special care units for people with dementia in Norway. If any drugs had been concealed in the food or beverages during the previous seven days without the patient's knowledge or consent, it was recorded, along with the reason for hiding the drugs.

They found that 11% of the patients in regular nursing homes and 17% of the patients in special care units received drugs mixed in their food or beverages at least once during seven days. In 95% of cases, this practice was routine, but was poorly documented in the patients' records. The procedure for the decision to hide drugs also seems to be arbitrary.

Patients with severe mental (cognitive) impairment, reduced function in activities of daily living, or aggressive behaviour were more often subjected to covert administration. Patients in special care units also had a higher risk of being given drugs covertly. These patients were most often given sedatives, probably to control and sedate demented patients with disturbed behaviour, suggest the authors.

The low rate of documentation and the secrecy surrounding this practice in institutions are a cause for concern, they conclude.

'"/>

Contact: Emma Dickinson
edickinson@bmj.com
44-207-383-6529
BMJ-British Medical Journal
22-Nov-2004