Potentially inappropriate psychotropic prescription at discharge is ă associated with lower functioning in the elderly psychiatric inpatients. ă A cross-sectional study

Guillaume Fond (), Claire Fajula, Daniel Dassa, Lore Brunel, Christophe Lançon () and Laurent Boyer ()
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Guillaume Fond: INSERM U955, équipe 15 - Service de psychiatrie - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Henri Mondor - Hôpital Albert Chenevier - Réseau de coopération scientifique en santé mentale - Fondation FondaMental [Créteil] - IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12
Daniel Dassa: Pôle psychiatrique Centre - APHM - Assistance Publique - Hôpitaux de Marseille - LA CONCEPTION - Hôpital de la Conception [CHU - APHM]
Christophe Lançon: Hôpitaux Sud - Département Universitaire de Psychiatrie - [Hôpital Sainte Marguerite - APHM] - AMU - Aix Marseille Université - APHM - Assistance Publique - Hôpitaux de Marseille - Hôpitaux Sud - Hôpital Sainte-Marguerite [CHU - APHM]
Laurent Boyer: C3M - Centre méditerranéen de médecine moléculaire - UNS - Université Nice Sophia Antipolis (1965 - 2019) - INSERM - Institut National de la Santé et de la Recherche Médicale - UniCA - Université Côte d'Azur

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Abstract: Objective The objectives are to determine the rate of potentially ă inappropriate psychotropic (PIP) prescription at discharge in the ă elderly psychiatric inpatients and to determine whether PIP is ă associated with lowered functioning outcomes. ă Methods Sociodemographic, clinical, and treatment data for all ă inpatients aged >= 65 years consecutively hospitalized during 1 year in ă 13 psychiatry departments was analyzed. PIP+/PIP- groups were defined ă according to the French-updated Beers criteria. Daily functioning was ă evaluated by the daily living (ADL) scale. Logistic regression analysis ă was used to estimate odds ratios for the association between PIP ă administration at discharge and respectively functioning and potential ă confounding factors. ă Results Data was obtained for 327 patients. Overall, 124 (37.9 %) ă patients were males, and the mean age was 73.9 years (SD=5.6); 163 ă (49.8%) patients were diagnosed with affective disorders and 89 ă (27.2%) with schizophrenia/schizotypal/delusional disorders. Overall, ă 249 (76.1 %) had one or more PIP medications, mainly anxiolytics (69.9 ă %) and hypnotics (17.2 %). In a multivariate analysis, PIP ă prescription at discharge has been associated with patient lowered ă personal care functioning, independently of age, gender, and psychiatric ă or somatic diagnoses (OR=0.88 (0.79-0.97, p=0.01). ă Conclusion In the current increasingly fragmented health care systems, ă special attention must be given to PIP prescription in older population ă suffering from psychiatric disorders. Using the Beers criteria, the ă present study demonstrates the high prevalence of PIP prescription, ă which concerns a large panel of drugs but mostly anxiolytics and ă hypnotics independently of psychiatric or somatic diagnoses and ă sociodemographic characteristics. Our study has demonstrated for the ă first time an association between PIP prescription and lowered patient ă functioning. Further longitudinal studies should confirm a potential ă causal relation.

Keywords: Quality; of; Life (search for similar items in EconPapers)
Date: 2016-07
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Citations: View citations in EconPapers (1)

Published in Psychopharmacology, 2016, 233 (13), pp.2549-2558. ⟨10.1007/s00213-016-4312-z⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-01482658

DOI: 10.1007/s00213-016-4312-z

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