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Elderly patients treated with psychotropic medicines admitted to hospital: associated characteristics and inappropriate use

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study is to describe the characteristics of older patients treated with psychotropic medicines and the associated factors and to assess their inappropriate use.

Methods

An observational, prospective study was carried out in 672 elderly patients admitted to seven hospitals for a year. A comparison of sociodemographic characteristics, geriatric variables, multimorbidity and the number of prescribed medicines taken in the preceding month before hospitalization between patients treated with psychotropics and those not treated was performed. To assess factors associated with psychotropics, multivariate logistic regression analyses were performed. Inappropriate use was assessed using the Beers and the STOPP criteria.

Results

A total of 57.5 % patients (median [Q1–Q3] age 81.7 [78.2–86.1], 65.7 % female) were treated with psychotropics (44.2 % anxiolytics, 22.6 % antidepressants and 10.8 % antipsychotics). Independent factors associated with the use of psychotropics were female gender (OR = 2.3; CI 95 %,1.6–3.5), some degree of disability on admission (slight [OR = 2.2; 1.2–4.2], moderate [OR = 3.2, 1.6–6.6], severe [OR = 3.4; 1.4–8] and very severe [OR = 5.1; 2.0–12.8]) and polypharmacy (5–9 medicines [OR = 3.0; 1.3–6.9] and ≥10 medicines [OR = 6.0; 2.7–13.6]). The associated factors varied depending on the different types of psychotropics. In patients treated with psychotropics, the percentage of those with at least one Beers (61.6 %) or at least one STOPP (71.4 %) criteria was significantly higher in comparison with those not treated with psychotropics (30.7 and 47.7 %, respectively, p < 0.001).

Conclusions

Psychotropics are widely used in the elderly population and often their use is inappropriate. Female gender, a poor functional status and polypharmacy, are the characteristics linked to their use. Interventional strategies should be focused on patients with these characteristics.

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Acknowledgments

The project was financed by Grant no. EC10-211 obtained in a request for aid for the promotion of independent clinical research (SAS/2370/2010 Order of 27 September from the Spanish Ministry of Health, Social Affairs and Equality).

Authors’ contributions

ASJ and AA, as directors and project leaders, had devised and wrote the proposal for obtaining the grant. XV, AA and AV wrote the manuscript and had final responsibility for the decision to submit the manuscript for publication. ASJ, AA, XV, FF, ALS, AFM, JG, NRD, OHT and JB contributed to the study design, coordinated data collection in each hospital, interpreted the data, reviewed the manuscript, provided comments and approved the final text of the manuscript. XV conducted statistical analysis. EB and EP controlled and monitorized quality data. XB designed the database. CA, CP, AT, CP, TT, DCh, BR, AV, CC, IB, DR, MT, PP, GO, PCRC, PG, MGH, RRM, MNB, XB, MJP, JR and MN collected the data.

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Authors and Affiliations

  1. Clinical Pharmacology Service, Fundació Institut Català de Farmacologia, Hospital Universitari Vall d’Hebron, Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Passeig Vall d’Hebron 119-129, 08035, Barcelona, Spain

    Xavier Vidal, Antonia Agustí & José Barbé

  2. Clinical Pharmacology Service, IDIBELL, Hospital Universitari de Bellvitge, Department of Pathology and Experimental Therapeutics, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain

    Antoni Vallano

  3. Internal Medicine Service, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain

    Francesc Formiga

  4. Multimorbidity and Elderly Patients Group of the Spanish Society of Internal Medicine, Barcelona, Spain

    Francesc Formiga, Antonio Fernández Moyano, Juana García, Alfonso López-Soto, Nieves Ramírez-Duque, Olga H. Torres, José Barbé & Antonio San-José

  5. Internal Medicine Service, Hospital San Juan De Dios del Aljarafe, Sevilla, Spain

    Antonio Fernández Moyano

  6. Internal Medicine Service, Hospital General Juan Ramón Jiménez, Huelva, Spain

    Juana García

  7. Internal Medicine Service, Hospital Clínic, Barcelona, Spain

    Alfonso López-Soto

  8. Internal Medicine Service, Hospital Universitario Virgen del Rocío, Sevilla, Spain

    Nieves Ramírez-Duque

  9. Internal Medicine Service, Hospital Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain

    Olga H. Torres

  10. Internal Medicine Service, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain

    Antonio San-José

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  1. Xavier Vidal
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  2. Antonia Agustí
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  3. Antoni Vallano
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  5. Antonio Fernández Moyano
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  6. Juana García
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  7. Alfonso López-Soto
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  8. Nieves Ramírez-Duque
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  9. Olga H. Torres
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  10. José Barbé
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  11. Antonio San-José
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on behalf of Potentially Inappropriate Prescription in Older Patients in Spain (PIPOPS) Investigators’ project

Corresponding author

Correspondence to Antonia Agustí.

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The authors declare that they have no competing interests.

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Vidal, X., Agustí, A., Vallano, A. et al. Elderly patients treated with psychotropic medicines admitted to hospital: associated characteristics and inappropriate use. Eur J Clin Pharmacol 72, 755–764 (2016). https://doi.org/10.1007/s00228-016-2032-2

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  • DOI: https://doi.org/10.1007/s00228-016-2032-2

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