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Prescribing psychotropic medication for elderly patients: some physicians' perspectives
N Damestoy1, J Collin, R Lalande
1Département de médecine sociale et préventive, Faculté de médecine, Université de Montréal, Que.
Summary
Physicians view psychotropic medication use in elderly patients as justified, but believe solutions to inappropriate prescribing require broader strategies beyond individual doctors. This highlights a need for public health interventions.
Area of Science:
- Geriatric Medicine
- Psychopharmacology
- Public Health
Background:
- Inappropriate psychotropic medication use in the elderly is a significant concern.
- This practice can negatively impact the autonomy of older adults.
Purpose of the Study:
- To explore physicians' perceptions and attitudes towards prescribing psychotropic medications for elderly patients.
- To understand the decision-making processes involved in this prescribing behavior.
Main Methods:
- Qualitative study involving interviews with 9 physicians providing consultation services to elderly individuals.
- Interviews conducted between February and April 1996 in Montreal.
- Analysis of interview transcripts using an iterative quantitative process.
Main Results:
- Physicians perceive aging negatively and justify long-term psychotropic medication for patient distress, noting few side effects.
- Most physicians adopt a "gatekeeper" role in re-prescribing to monitor medication.
- Physicians believe addressing inappropriate prescribing requires solutions beyond individual physician scope.
Conclusions:
- Physicians demonstrated a patient-centered perspective in their prescribing practices.
- An innovative, multidisciplinary public health approach is needed to address inappropriate psychotropic medication use in the elderly.