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Psychotropic Medicine Utilization in Older People in New Zealand from 2005 to 2013

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Abstract

Background

Psychotropic medicine utilization has increased worldwide among older people (aged 65 years or older), in relation to utilization of other medicines.

Objective

The aim of this population-level study was to describe and characterize the national utilization of psychotropic medicines in older people in New Zealand between 2005 and 2013.

Methods

Repeated cross-sectional analysis of population-level dispensing data was conducted from 1 January 2005 to 31 December 2013. Data on utilization of psychotropic medicines were extracted and categorized in accordance with the World Health Organization Collaborating Centre for Drug Statistics Methodology’s Anatomical Therapeutic Chemical classification system. Utilization was measured in terms of the defined daily dose (DDD) per 1,000 older people per day (TOPD).

Results

Overall, utilization of psychotropic medicines showed a 22.5 % increase between 2005 and 2013. Utilization increased for antidepressants (from 81.9 to 110.4 DDD/TOPD), antipsychotics (from 6.8 to 8.7 DDD/TOPD) and hypnotics and sedatives (from 59.4 to 65.5 DDD/TOPD); in contrast, utilization of anxiolytics decreased (from 11.4 to 10.7 DDD/TOPD). Utilization of atypical antipsychotics increased (from 4.6 to 6.8 DDD/TOPD), with the highest percentage change in DDD/TOPD being contributed by olanzapine (112.1 %), while utilization of typical antipsychotics declined (from 2.0 to 1.5 DDD/TOPD). Utilization of tetracyclic antidepressants and venlafaxine grew rapidly by 1.5 and 4.5 times, respectively, between 2005 and 2013. Utilization of zopiclone was greater than that of other hypnotics in 2013.

Conclusion

Utilization of psychotropic medicines in older people increased by one fifth between 2005 and 2013. Important findings of this study were that: (1) there was a marked increase in utilization of recently funded antidepressants; (2) utilization of atypical antipsychotics increased; (3) there was a move towards utilization of selective serotonin reuptake inhibitors; (4) utilization of zopiclone remained high; and (5) low, standard and high DDD utilization all increased with time.

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Acknowledgments

The authors thank the Analytical Services, New Zealand Ministry of Health, for supplying the dispensing data extracted from the Pharms database. Henry C. Ndukwe was funded by a doctoral scholarship from the University of Otago, Dunedin, New Zealand.

Disclosure statement The funder had no role in the study design, data collection, data analysis or data interpretation.

Conflict of interest

None of the authors has any conflict of interest to declare.

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Authors and Affiliations

  1. School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, New Zealand

    Henry C. Ndukwe, June M. Tordoff & Prasad S. Nishtala

  2. Department of Mathematics and Statistics, University of Otago, Dunedin, New Zealand

    Ting Wang

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  1. Henry C. Ndukwe
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  2. June M. Tordoff
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Correspondence to Prasad S. Nishtala.

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Ndukwe, H.C., Tordoff, J.M., Wang, T. et al. Psychotropic Medicine Utilization in Older People in New Zealand from 2005 to 2013. Drugs Aging 31, 755–768 (2014). https://doi.org/10.1007/s40266-014-0205-1

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