{"title":"The Influence of Frailty on Pharmacotherapy Adherence and Adverse Drug Reactions in Older Psychiatric Patients.","authors":"Tuan Anh Phan, Rob Kok","doi":"10.3390/geriatrics10020057","DOIUrl":null,"url":null,"abstract":"<p><p><b>Aim/Objectives</b>: To investigate whether frailty predicts adherence to psychotropic drug treatment or adverse drug reactions, within 6 months after treatment initiation. <b>Methods</b>: A prospective cohort study including 77 patients over the age of 65, treated in one large psychiatric institute in the Netherlands. Patients were assessed at baseline for their frailty status, using different operationalizations of the Fried frailty criteria. Data on duration of psychotropic drug treatment and number of reported adverse drug reactions were retrieved from electronic patient files. Regression analyses were adjusted for age, sex, patient setting, and polypharmacy as potential confounders. <b>Results</b>: Frail patients were not significantly more likely to discontinue psychotropic treatment than non-frail patients (OR = 1.4; 95% CI 0.6-3.7, <i>p</i> = 0.468). Time to treatment discontinuation was also not statistically different between both study groups (HR = 0.8; 95% CI 0.4-1.6, <i>p</i> = 0.498), and neither was the number of adverse drug reactions (OR = 1.6, 95% CI 0.6-4.1, <i>p</i> = 0.345). <b>Conclusions</b>: We could not demonstrate a statistically significant effect of frailty as predictor of discontinuing psychotropic treatment or adverse drug reactions, but a lack of power may also explain our results. A more comprehensive frailty assessment may be needed to predict treatment adherence or adverse drug reactions in psychiatric patients.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 2","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026496/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Geriatrics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3390/geriatrics10020057","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Aim/Objectives: To investigate whether frailty predicts adherence to psychotropic drug treatment or adverse drug reactions, within 6 months after treatment initiation. Methods: A prospective cohort study including 77 patients over the age of 65, treated in one large psychiatric institute in the Netherlands. Patients were assessed at baseline for their frailty status, using different operationalizations of the Fried frailty criteria. Data on duration of psychotropic drug treatment and number of reported adverse drug reactions were retrieved from electronic patient files. Regression analyses were adjusted for age, sex, patient setting, and polypharmacy as potential confounders. Results: Frail patients were not significantly more likely to discontinue psychotropic treatment than non-frail patients (OR = 1.4; 95% CI 0.6-3.7, p = 0.468). Time to treatment discontinuation was also not statistically different between both study groups (HR = 0.8; 95% CI 0.4-1.6, p = 0.498), and neither was the number of adverse drug reactions (OR = 1.6, 95% CI 0.6-4.1, p = 0.345). Conclusions: We could not demonstrate a statistically significant effect of frailty as predictor of discontinuing psychotropic treatment or adverse drug reactions, but a lack of power may also explain our results. A more comprehensive frailty assessment may be needed to predict treatment adherence or adverse drug reactions in psychiatric patients.
目的:探讨在治疗开始后6个月内,身体虚弱是否能预测精神药物治疗的依从性或药物不良反应。方法:一项前瞻性队列研究,包括77名65岁以上的患者,在荷兰一家大型精神病研究所接受治疗。患者在基线时评估他们的虚弱状态,使用不同的Fried虚弱标准操作。精神药物治疗的持续时间和报告的药物不良反应的数量数据从电子患者档案中检索。将年龄、性别、患者环境和多种药物作为潜在的混杂因素对回归分析进行调整。结果:体弱患者停止精神药物治疗的可能性不高于非体弱患者(OR = 1.4;95% CI 0.6-3.7, p = 0.468)。两组间治疗停止时间也无统计学差异(HR = 0.8;95% CI 0.4 ~ 1.6, p = 0.498),药物不良反应次数也无统计学意义(OR = 1.6, 95% CI 0.6 ~ 4.1, p = 0.345)。结论:我们不能证明虚弱作为停止精神药物治疗或药物不良反应的预测因子有统计学意义,但缺乏权力也可以解释我们的结果。可能需要更全面的虚弱评估来预测精神病患者的治疗依从性或药物不良反应。
期刊介绍:
• Geriatric biology
• Geriatric health services research
• Geriatric medicine research
• Geriatric neurology, stroke, cognition and oncology
• Geriatric surgery
• Geriatric physical functioning, physical health and activity
• Geriatric psychiatry and psychology
• Geriatric nutrition
• Geriatric epidemiology
• Geriatric rehabilitation