Psychoactive prescribing for older people-what difference does 15 years make?

Lloyd D. Hughes, Lynda Cochrane, Marion E. T. McMurdo, Bruce Guthrie (Lead / Corresponding author)

Research output: Contribution to journalArticle

4 Citations (Scopus)
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Abstract

Objective: The objective of the study was to review prescribing of psychoactive medications for older residents of the Tayside region of Scotland. Methods: The analysis used community prescribing data in 1995 and 2010 for all older residents in Tayside. For each psychoactive drug class, the name of the most recently prescribed drug and the date prescribed were extracted. The relative risk (RR) and 95% confidence intervals (CI) for patients receiving psychoactive medication in 2010 were compared with those for patients in 1995. Psychoactive prescribing was analyzed by year, age, gender, and deprivation classification. The chi-squared test was used to calculate statistical significance. Results: Total psychoactive prescribing in people over the age of 65years has increased comparing 1995 with 2010. Antidepressant [RR=2.5 (95% CI 2.41-2.59) p<0.001] and opioid analgesia [RR=1.21 (1.19-1.24) p<0.001] prescriptions increased between 1995 and 2010. Hypnotics/anxiolytic [RR=0.69 (0.66-0.71) p<0.001] and antipsychotic [RR=0.83 (0.77-0.88) p<0.001] prescriptions decreased between 1995 and 2010. An increase in psychoactive prescribing is particularly marked in lower socioeconomic groups. Patients in the least affluent fifth of the population had RR=1.25 (1.20-1.29) [p<0.001] of being prescribed one to two psychoactive medications and RR=1.81 (1.56-2.10) [p<0.001] of being prescribed three or more psychoactive medications in 2010 compared with those in 1995. The RRs for the most affluent fifth were RR=1.14 (1.1-1.19) [p<0.001] and RR=1.2 (1.01-1.42) [p<0.001] for one to two, and three or more medications, respectively. Conclusion: Psychoactive medication prescribing has increased comparing 1995 with 2010, with increases disproportionately affecting patients in lower socioeconomic groups. The availability of new psychoactive drugs, safety concerns, and economic factors may explain these increases.

Original languageEnglish
Pages (from-to)49-57
Number of pages9
JournalInternational Journal of Geriatric Psychiatry
Volume31
Issue number1
Early online date17 Apr 2015
DOIs
Publication statusPublished - Jan 2016

Fingerprint

Psychotropic Drugs
Prescriptions
Confidence Intervals
Anti-Anxiety Agents
Scotland
Hypnotics and Sedatives
Analgesia
Opioid Analgesics
Antidepressive Agents
Antipsychotic Agents
Names
Economics
Safety
Pharmaceutical Preparations
Population

Keywords

  • older people
  • prescription
  • psychoactive prescribing

Cite this

@article{0296333058da4e96b36ed88609079aa6,
title = "Psychoactive prescribing for older people-what difference does 15 years make?",
abstract = "Objective: The objective of the study was to review prescribing of psychoactive medications for older residents of the Tayside region of Scotland. Methods: The analysis used community prescribing data in 1995 and 2010 for all older residents in Tayside. For each psychoactive drug class, the name of the most recently prescribed drug and the date prescribed were extracted. The relative risk (RR) and 95{\%} confidence intervals (CI) for patients receiving psychoactive medication in 2010 were compared with those for patients in 1995. Psychoactive prescribing was analyzed by year, age, gender, and deprivation classification. The chi-squared test was used to calculate statistical significance. Results: Total psychoactive prescribing in people over the age of 65years has increased comparing 1995 with 2010. Antidepressant [RR=2.5 (95{\%} CI 2.41-2.59) p<0.001] and opioid analgesia [RR=1.21 (1.19-1.24) p<0.001] prescriptions increased between 1995 and 2010. Hypnotics/anxiolytic [RR=0.69 (0.66-0.71) p<0.001] and antipsychotic [RR=0.83 (0.77-0.88) p<0.001] prescriptions decreased between 1995 and 2010. An increase in psychoactive prescribing is particularly marked in lower socioeconomic groups. Patients in the least affluent fifth of the population had RR=1.25 (1.20-1.29) [p<0.001] of being prescribed one to two psychoactive medications and RR=1.81 (1.56-2.10) [p<0.001] of being prescribed three or more psychoactive medications in 2010 compared with those in 1995. The RRs for the most affluent fifth were RR=1.14 (1.1-1.19) [p<0.001] and RR=1.2 (1.01-1.42) [p<0.001] for one to two, and three or more medications, respectively. Conclusion: Psychoactive medication prescribing has increased comparing 1995 with 2010, with increases disproportionately affecting patients in lower socioeconomic groups. The availability of new psychoactive drugs, safety concerns, and economic factors may explain these increases.",
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Psychoactive prescribing for older people-what difference does 15 years make? / Hughes, Lloyd D.; Cochrane, Lynda; McMurdo, Marion E. T.; Guthrie, Bruce (Lead / Corresponding author).

In: International Journal of Geriatric Psychiatry, Vol. 31, No. 1, 01.2016, p. 49-57.

Research output: Contribution to journalArticle

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N2 - Objective: The objective of the study was to review prescribing of psychoactive medications for older residents of the Tayside region of Scotland. Methods: The analysis used community prescribing data in 1995 and 2010 for all older residents in Tayside. For each psychoactive drug class, the name of the most recently prescribed drug and the date prescribed were extracted. The relative risk (RR) and 95% confidence intervals (CI) for patients receiving psychoactive medication in 2010 were compared with those for patients in 1995. Psychoactive prescribing was analyzed by year, age, gender, and deprivation classification. The chi-squared test was used to calculate statistical significance. Results: Total psychoactive prescribing in people over the age of 65years has increased comparing 1995 with 2010. Antidepressant [RR=2.5 (95% CI 2.41-2.59) p<0.001] and opioid analgesia [RR=1.21 (1.19-1.24) p<0.001] prescriptions increased between 1995 and 2010. Hypnotics/anxiolytic [RR=0.69 (0.66-0.71) p<0.001] and antipsychotic [RR=0.83 (0.77-0.88) p<0.001] prescriptions decreased between 1995 and 2010. An increase in psychoactive prescribing is particularly marked in lower socioeconomic groups. Patients in the least affluent fifth of the population had RR=1.25 (1.20-1.29) [p<0.001] of being prescribed one to two psychoactive medications and RR=1.81 (1.56-2.10) [p<0.001] of being prescribed three or more psychoactive medications in 2010 compared with those in 1995. The RRs for the most affluent fifth were RR=1.14 (1.1-1.19) [p<0.001] and RR=1.2 (1.01-1.42) [p<0.001] for one to two, and three or more medications, respectively. Conclusion: Psychoactive medication prescribing has increased comparing 1995 with 2010, with increases disproportionately affecting patients in lower socioeconomic groups. The availability of new psychoactive drugs, safety concerns, and economic factors may explain these increases.

AB - Objective: The objective of the study was to review prescribing of psychoactive medications for older residents of the Tayside region of Scotland. Methods: The analysis used community prescribing data in 1995 and 2010 for all older residents in Tayside. For each psychoactive drug class, the name of the most recently prescribed drug and the date prescribed were extracted. The relative risk (RR) and 95% confidence intervals (CI) for patients receiving psychoactive medication in 2010 were compared with those for patients in 1995. Psychoactive prescribing was analyzed by year, age, gender, and deprivation classification. The chi-squared test was used to calculate statistical significance. Results: Total psychoactive prescribing in people over the age of 65years has increased comparing 1995 with 2010. Antidepressant [RR=2.5 (95% CI 2.41-2.59) p<0.001] and opioid analgesia [RR=1.21 (1.19-1.24) p<0.001] prescriptions increased between 1995 and 2010. Hypnotics/anxiolytic [RR=0.69 (0.66-0.71) p<0.001] and antipsychotic [RR=0.83 (0.77-0.88) p<0.001] prescriptions decreased between 1995 and 2010. An increase in psychoactive prescribing is particularly marked in lower socioeconomic groups. Patients in the least affluent fifth of the population had RR=1.25 (1.20-1.29) [p<0.001] of being prescribed one to two psychoactive medications and RR=1.81 (1.56-2.10) [p<0.001] of being prescribed three or more psychoactive medications in 2010 compared with those in 1995. The RRs for the most affluent fifth were RR=1.14 (1.1-1.19) [p<0.001] and RR=1.2 (1.01-1.42) [p<0.001] for one to two, and three or more medications, respectively. Conclusion: Psychoactive medication prescribing has increased comparing 1995 with 2010, with increases disproportionately affecting patients in lower socioeconomic groups. The availability of new psychoactive drugs, safety concerns, and economic factors may explain these increases.

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