{"title":"Psychotropic Drug Use and Associated Factors Among Acutely Admitted Older People: A Cross-Sectional Study of a Clinical Sample.","authors":"Ema Gasi, Maria Gustafsson, Jonas Kindstedt","doi":"10.1007/s40801-024-00455-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Older people are on average more susceptible to the adverse effects of psychotropic drugs, but addressing older people as a homogenous group based on age alone can be misleading when exploring psychotropic drug use. This study aimed to describe psychotropic drug use and associated factors among community-dwelling older people who had been acutely admitted to hospital.</p><p><strong>Methods: </strong>This cross-sectional study was based on a sample of 300 community-dwelling people 75 years or older who had been admitted to the acute medical ward at Umeå University Hospital at any time from September 2018 to October 2021. Data on medication use were obtained from electronic medical charts, and psychotropic drug use was presented as user proportions, both in terms of individual substances and drug classes. Associations between psychotropic drug use and factors comprising sex, age, cohabitation, comorbidities and multi-dose dispensing (MDD) of medicines were analysed through logistic regression.</p><p><strong>Results: </strong>Approximately 50% of the individuals used at least one psychotropic drug, and 18% used two or more such medicines. Zopiclone displayed the highest user proportion of all psychotropics (18.3%), followed by mirtazapine (11.3%) and zolpidem (9.7%). Of note, zolpidem was more prevalent among the females than among the males (p = 0.006). Regarding other sex differences, 55 and 38% of the females and males, respectively, used at least one psychotropic drug (p = 0.004). A similar pattern was observed regarding sedatives and hypnotic drugs exclusively (p = 0.048). In the regression analysis, female sex (adjusted odds ratio [OR] 2.05 [95% confidence interval {CI} 1.22-3.42]) and MDD (adjusted OR 2.20 [95% CI 1.23-3.93]) were positively associated with psychotropic drug use.</p><p><strong>Conclusion: </strong>The most common psychotropic drugs used by community-dwelling older people admitted to the acute medical ward were hypnotic drugs and antidepressants. Regarding patient factors, female sex and MDD system were positively associated with psychotropic drug use. Further studies concerning those two factors in relation to potential overprescribing could provide a better picture on how to optimize psychotropic drug use among acutely admitted vulnerable older people.</p>","PeriodicalId":11282,"journal":{"name":"Drugs - Real World Outcomes","volume":" ","pages":"627-633"},"PeriodicalIF":1.9000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589078/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Drugs - Real World Outcomes","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s40801-024-00455-w","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/24 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Older people are on average more susceptible to the adverse effects of psychotropic drugs, but addressing older people as a homogenous group based on age alone can be misleading when exploring psychotropic drug use. This study aimed to describe psychotropic drug use and associated factors among community-dwelling older people who had been acutely admitted to hospital.
Methods: This cross-sectional study was based on a sample of 300 community-dwelling people 75 years or older who had been admitted to the acute medical ward at Umeå University Hospital at any time from September 2018 to October 2021. Data on medication use were obtained from electronic medical charts, and psychotropic drug use was presented as user proportions, both in terms of individual substances and drug classes. Associations between psychotropic drug use and factors comprising sex, age, cohabitation, comorbidities and multi-dose dispensing (MDD) of medicines were analysed through logistic regression.
Results: Approximately 50% of the individuals used at least one psychotropic drug, and 18% used two or more such medicines. Zopiclone displayed the highest user proportion of all psychotropics (18.3%), followed by mirtazapine (11.3%) and zolpidem (9.7%). Of note, zolpidem was more prevalent among the females than among the males (p = 0.006). Regarding other sex differences, 55 and 38% of the females and males, respectively, used at least one psychotropic drug (p = 0.004). A similar pattern was observed regarding sedatives and hypnotic drugs exclusively (p = 0.048). In the regression analysis, female sex (adjusted odds ratio [OR] 2.05 [95% confidence interval {CI} 1.22-3.42]) and MDD (adjusted OR 2.20 [95% CI 1.23-3.93]) were positively associated with psychotropic drug use.
Conclusion: The most common psychotropic drugs used by community-dwelling older people admitted to the acute medical ward were hypnotic drugs and antidepressants. Regarding patient factors, female sex and MDD system were positively associated with psychotropic drug use. Further studies concerning those two factors in relation to potential overprescribing could provide a better picture on how to optimize psychotropic drug use among acutely admitted vulnerable older people.
期刊介绍:
Drugs - Real World Outcomes targets original research and definitive reviews regarding the use of real-world data to evaluate health outcomes and inform healthcare decision-making on drugs, devices and other interventions in clinical practice. The journal includes, but is not limited to, the following research areas: Using registries/databases/health records and other non-selected observational datasets to investigate: drug use and treatment outcomes prescription patterns drug safety signals adherence to treatment guidelines benefit : risk profiles comparative effectiveness economic analyses including cost-of-illness Data-driven research methodologies, including the capture, curation, search, sharing, analysis and interpretation of ‘big data’ Techniques and approaches to optimise real-world modelling.