Potentially inappropriate prescriptions for elderly people taking antidepressant: comparative tools

Area of Science:

• Geriatrics
• Pharmacology
• Public Health

Background:

• Psychotropic drug use is common in the elderly worldwide, with frequent inappropriate medication use.
• In Brazil, elderly individuals are particularly vulnerable to Potentially Inappropriate Psychotropic (PIP) use due to socioeconomic factors, public health system limitations, and inadequate patient monitoring.
• Previous studies have not investigated the prevalence or patterns of PIP use in Brazil.

Purpose of the Study:

• To determine the prevalence of Potentially Inappropriate Psychotropic (PIP) use in elderly outpatients prescribed antidepressants in Brazil.
• To compare the effectiveness of the Beers and STOPP criteria in identifying PIP in this population.

Main Methods:

• A cross-sectional study was conducted on elderly outpatients (≥ 60 years) taking antidepressants within the Brazilian public health system.
• Data were extracted from pharmacy databases and medical records for psychotropic medications including antidepressants, antipsychotics, anti-epileptics, and benzodiazepines.
• The Beers and STOPP criteria were applied to screen for Potentially Inappropriate Psychotropic (PIP) use.

Main Results:

• The study analyzed 1,140 prescriptions from 174 outpatients, with an average age of 67 years and a median of 3 medications per patient.
• The overall prevalence of Potentially Inappropriate Psychotropic (PIP) use was high at 69.5%.
• The STOPP criteria identified PIP in 39.6% of patients, while the Beers criteria identified it in 29.9%. Long-term benzodiazepine use was the most frequent type of PIP.

Conclusions:

• Potentially Inappropriate Psychotropic (PIP) use is highly prevalent among elderly outpatients in Brazil.
• The STOPP criteria demonstrated a higher detection rate for PIP compared to the Beers criteria.
• Findings underscore the need for targeted interventions to reduce inappropriate prescriptions and suggest the development of national criteria for PIP in Brazil.