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Potentially inappropriate psychotropic prescription at discharge is associated with lower functioning in the elderly

Guillaume Fond1,2,3,4, Claire Fajula5, Daniel Dassa6

  • 1Fondation FondaMental, Créteil, France. guillaume.fond@gmail.com.

Psychopharmacology
|May 1, 2016
PubMed

Insights

Potentially inappropriate psychotropic (PIP) medications were prescribed to over 76% of elderly psychiatric inpatients at discharge. PIP prescription was linked to worse patient functioning, highlighting the need for careful prescribing in this vulnerable population.

Area of Science:

  • Geriatric Psychiatry
  • Psychopharmacology
  • Health Services Research

Background:

  • Potentially inappropriate psychotropic (PIP) medications are frequently prescribed to elderly psychiatric inpatients.
  • The impact of PIP on functional outcomes in this population remains under-investigated.

Purpose of the Study:

  • To determine the rate of PIP prescription at hospital discharge among elderly psychiatric inpatients.
  • To assess the association between PIP prescription and functional outcomes in this patient group.

Main Methods:

  • A retrospective analysis of sociodemographic, clinical, and treatment data from 327 elderly (≥65 years) psychiatric inpatients across 13 departments.
  • Patients were categorized into PIP+ and PIP- groups based on French-updated Beers criteria.
  • Functional status was measured using the Activities of Daily Living (ADL) scale, and logistic regression was employed to analyze associations.

Main Results:

  • A high prevalence of PIP prescription was observed, with 76.1% of patients receiving at least one PIP medication, primarily anxiolytics (69.9%) and hypnotics (17.2%).
  • Multivariate analysis revealed that PIP prescription at discharge was significantly associated with lowered personal care functioning (OR=0.88, p=0.01), independent of other factors.
  • No significant association was found with age, gender, or psychiatric/somatic diagnoses.

Conclusions:

  • The study highlights a high rate of potentially inappropriate psychotropic medication use in elderly psychiatric inpatients upon discharge.
  • For the first time, a significant association between PIP prescription and diminished patient functioning has been demonstrated.
  • Further research, including longitudinal studies, is warranted to establish a causal relationship and inform clinical practice.
Abstract

Keywords:
BenzodiazepinesElderlyFunctioningInpatientPotentially inappropriate psychotropic prescriptionPsychiatric disorder

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