Potentially inappropriate medication in older psychiatric patients.
Age Factors
Aged
Aged, 80 and over
Drug-Related Side Effects and Adverse Reactions
/ epidemiology
Female
Hospitalization
Humans
Inappropriate Prescribing
/ statistics & numerical data
Length of Stay
Longitudinal Studies
Male
Mental Disorders
/ drug therapy
Pharmacovigilance
Potentially Inappropriate Medication List
Prevalence
Psychotropic Drugs
/ administration & dosage
Retrospective Studies
Older patients
PRISCUS list
Potentially inappropriate medication
Psychiatry
Psychopharmacology
Journal
European journal of clinical pharmacology
ISSN: 1432-1041
Titre abrégé: Eur J Clin Pharmacol
Pays: Germany
ID NLM: 1256165
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
23
04
2020
accepted:
01
10
2020
pubmed:
9
10
2020
medline:
1
10
2021
entrez:
8
10
2020
Statut:
ppublish
Résumé
Many psychotropic drugs are listed as potentially inappropriate medication (PIM) in the older population. Potentially inappropriate means that prescription of those drugs in older adults may cause significant harm. The objective of this study was to analyze the prevalence and sort of PIM prescribing in a naturalistic, real-world psychiatric setting. The retrospective analysis gathered data from a large pharmacovigilance study, conducted at 10 psychiatric hospitals. Data from inpatients aged ≥ 65 years were included for the analysis. The number and sort of PIM, as defined by the German PRISCUS list, were controlled by analyzing the patients' medication profile. In total, 4760 patient cases (59.2% female) with a mean (mean ± standard deviation (SD)) age of 77.33 ± 7.77 years were included into the study. Altogether, 1615 cases (33.9%) received at least 1 PRISCUS-PIM per day (regular and as-needed medication included). The most frequently prescribed PRISCUS-PIM (n = 2144) were zopiclone > 3.75 mg/day (n = 310), lorazepam > 2 mg/day (n = 269), haloperidol > 2 mg/day (n = 252), and diazepam (n = 182). Cases with PRISCUS-PIM were younger (75.7 vs. 78.2 years, p < 0.001) and had a longer (26 vs. 22 days, p < 0.001) hospital length of stay. Replacing benzodiazepines and z-substances, haloperidol > 2 mg, tricyclic antidepressants, first generation antihistaminergic drugs, and clonidine by non-PIM could reduce 69.9% of PRISCUS-PIM-prescribing. The prevalence of PRISCUS-PIM is high in the hospitalized psychiatric setting. Rational deprescribing of inappropriate anticholinergics, benzodiazepines, and antipsychotics in the older population is a key component to reduce the risk of adverse drug reactions. More tolerable medications should be prescribed.
Identifiants
pubmed: 33029652
doi: 10.1007/s00228-020-03012-w
pii: 10.1007/s00228-020-03012-w
doi:
Substances chimiques
Psychotropic Drugs
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
331-339Références
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