 |
|
Prescribing Potentially Inappropriate Psychotropic Medications to the Ambulatory Elderly
Jane R. Mort, PharmD;
Rajender R. Aparasu, PhD
Arch Intern Med. 2000;160:2825-2831.
Background Psychotropic agents account for 23% to 51% of all inappropriate medications prescribed based on 1991 inappropriate medication criteria for nursing home residents. The criteria were revised to apply to all people older than 65 years. This study used the revised criteria in ambulatory settings to quantify potentially inappropriate prescription of psychotropic agents and identify associated characteristics.
Methods The 1996 public use data files of the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey were analyzed for inappropriate prescription of psychotropic medications for the elderly in office-based settings and outpatient departments. Disease-independent and disease-dependent criteria were analyzed.
Results Elderly patients were prescribed a psychotropic agent in 8.7% of all visits, antidepressant and antianxiety agents being the most frequently prescribed medications. Commonly, elderly patients receiving psychotropic agents were female, white, aged between 65 and 74 years, and received health care in a metropolitan area. Potentially inappropriate psychotropic agents were prescribed in 27.2% of all visits involving a psychotropic agent for the elderly. Disease-independent criteria (eg, antidepressant agents and long-acting benzodiazepines) accounted for most of the potentially inappropriate prescriptions. Factors positively associated with potentially inappropriate prescriptions included older age, "seen before" status, and antidepressant drug class, while enrollment in Medicaid, antipsychotic drug class, living in the Northeast region, and receiving health care in a metropolitan area were negatively associated.
Conclusions Potentially inappropriate prescription of psychotropic agents is very common for the elderly patient in the ambulatory setting. By focusing on the agents most frequently involved (eg, amitriptyline and long-acting benzodiazepines), provider characteristics (eg, location), and patient characteristics (eg, age), the greatest impact on potentially inappropriate prescribing can be achieved.
From the College of Pharmacy, South Dakota State University, Brookings.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati
What's this?
RELATED ARTICLE
Archives of Internal Medicine Reader's Choice: Continuing Medical Education
Arch Intern Med. 2000;160(18):2872-2873.
FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Assessing Multiple Medication Use With Probabilities of Benefits and Harms
Murphy et al.
J Aging Health 2008;20:694-709.
ABSTRACT
Impact of an interdisciplinary team on drug therapy outcomes in a geriatric clinic
Lam and Ruby
Am J Health Syst Pharm 2005;62:626-629.
FULL TEXT
Postoperative Confusion Increases in Elderly Long-Term Benzodiazepine Users
Kudoh et al.
Anesth. Analg. 2004;99:1674-1678.
ABSTRACT
| FULL TEXT
Updating the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults: Results of a US Consensus Panel of Experts
Fick et al.
Arch Intern Med 2003;163:2716-2724.
ABSTRACT
| FULL TEXT
Potentially Inappropriate Medication Use by Elderly Mexican Americans
Raji et al.
The Annals of Pharmacotherapy 2003;37:1197-1202.
ABSTRACT
| FULL TEXT
Medication Decisions--Right and Wrong
Stuart and Briesacher
Med Care Res Rev 2002;59:123-145.
ABSTRACT
Potentially Inappropriate Medication Use in the Community-Dwelling Elderly: Findings From the 1996 Medical Expenditure Panel Survey
Zhan et al.
JAMA 2001;286:2823-2829.
ABSTRACT
| FULL TEXT
|
