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Potentially inappropriate psychotropic prescription at discharge is ă associated with lower functioning in the elderly psychiatric inpatients. ă A cross-sectional study

Authors :
Laurent Boyer
Guillaume Fond
Christophe Lançon
Claire Fajula
Lore Brunel
D. Dassa
INSERM U955, équipe 15
Service de psychiatrie
Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier-Réseau de coopération scientifique en santé mentale
Fondation FondaMental [Créteil]-Fondation FondaMental [Créteil]-Institut Mondor de Recherche Biomédicale (IMRB)
Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)
Pôle psychiatrique Centre
Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)
Département Universitaire de Psychiatrie - [Hôpital Sainte Marguerite - APHM] (Hôpitaux Sud)
Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )
Centre méditerranéen de médecine moléculaire (C3M)
Université Nice Sophia Antipolis (1965 - 2019) (UNS)
COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA)
Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10
Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)
Université Nice Sophia Antipolis (... - 2019) (UNS)
Source :
Psychopharmacology, Psychopharmacology, Springer Verlag, 2016, 233 (13), pp.2549-2558. ⟨10.1007/s00213-016-4312-z⟩
Publication Year :
2016
Publisher :
HAL CCSD, 2016.

Abstract

International audience; Objective The objectives are to determine the rate of potentially ă inappropriate psychotropic (PIP) prescription at discharge in the ă elderly psychiatric inpatients and to determine whether PIP is ă associated with lowered functioning outcomes. ă Methods Sociodemographic, clinical, and treatment data for all ă inpatients aged >= 65 years consecutively hospitalized during 1 year in ă 13 psychiatry departments was analyzed. PIP+/PIP- groups were defined ă according to the French-updated Beers criteria. Daily functioning was ă evaluated by the daily living (ADL) scale. Logistic regression analysis ă was used to estimate odds ratios for the association between PIP ă administration at discharge and respectively functioning and potential ă confounding factors. ă Results Data was obtained for 327 patients. Overall, 124 (37.9 %) ă patients were males, and the mean age was 73.9 years (SD=5.6); 163 ă (49.8%) patients were diagnosed with affective disorders and 89 ă (27.2%) with schizophrenia/schizotypal/delusional disorders. Overall, ă 249 (76.1 %) had one or more PIP medications, mainly anxiolytics (69.9 ă %) and hypnotics (17.2 %). In a multivariate analysis, PIP ă prescription at discharge has been associated with patient lowered ă personal care functioning, independently of age, gender, and psychiatric ă or somatic diagnoses (OR=0.88 (0.79-0.97, p=0.01). ă Conclusion In the current increasingly fragmented health care systems, ă special attention must be given to PIP prescription in older population ă suffering from psychiatric disorders. Using the Beers criteria, the ă present study demonstrates the high prevalence of PIP prescription, ă which concerns a large panel of drugs but mostly anxiolytics and ă hypnotics independently of psychiatric or somatic diagnoses and ă sociodemographic characteristics. Our study has demonstrated for the ă first time an association between PIP prescription and lowered patient ă functioning. Further longitudinal studies should confirm a potential ă causal relation.

Details

Language :
English
ISSN :
00333158 and 14322072
Database :
OpenAIRE
Journal :
Psychopharmacology, Psychopharmacology, Springer Verlag, 2016, 233 (13), pp.2549-2558. ⟨10.1007/s00213-016-4312-z⟩
Accession number :
edsair.doi.dedup.....33bb6befb9fed04a43ab8439ac31f131