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The effects of medication assessment on psychotropic drug use in the community-dwelling elderly

Published online by Cambridge University Press:  14 September 2010

Maria Rikala ,
Maarit Jaana Korhonen ,
Raimo Sulkava  and
Sirpa Hartikainen
Maria Rikala*
Affiliation:
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland School of Pharmacy/Social Pharmacy, University of Eastern Finland, Kuopio, Finland
Maarit Jaana Korhonen
Affiliation:
Department of Pharmacology, Drug Development and Therapeutics, University of Turku, Turku, Finland
Raimo Sulkava
Affiliation:
Institute of Public Health and Clinical Nutrition, Department of Geriatrics, University of Eastern Finland, Kuopio, Finland Department of Neurology, Kuopio University Hospital, Kuopio, Finland
Sirpa Hartikainen
Affiliation:
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland School of Pharmacy/Clinical Pharmacology and Geriatric Pharmacotherapy, University of Eastern Finland, Kuopio, Finland Leppävirta Health Centre, Leppävirta, Finland
*
Correspondence should be addressed to: Maria Rikala, School of Pharmacy, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland, Phone +358 40 355 3125; Fax +358 17 162515. Email: [email protected].
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Abstract

Background: The study evaluated the effects of an annual medication assessment conducted as part of a Comprehensive Geriatric Assessment (CGA) on the prevalence of psychotropic drug use in community-dwelling elderly people.

Methods: Randomly selected persons (n = 1000) aged ≥75 years living in the city of Kuopio, Finland were randomized to intervention and control groups. The intervention group underwent an annual (2004–2006) medication assessment as part of a CGA by physicians. Data on drug use were gathered by interviews at baseline (2004) and in three following years (2005–2007). Generalized estimating equations (GEE) were applied to explore whether the prevalence of psychotropic drug use differed between the community-dwelling participants of the intervention (n = 361) and control groups (n = 339) over time.

Results: At baseline, nearly 40% of the participants used psychotropic drugs in each group. In the intervention group, the study physicians implemented 126 psychotropic drug-related changes, 39% of which were persistent after one year. The prevalence of use of psychotropic drugs, antipsychotics and anxiolytic/hypnotics did not differ between the groups over time. The prevalence of antidepressant use remained constant in the intervention group, but increased in the control group (p-value for interaction = 0.039). The prevalence of concomitant use of psychotropic drugs decreased non-significantly in the intervention group, but increased in the control group (p-value for interaction = 0.009).

Conclusions: Conducting an annual medication assessment outside the usual primary health care system does not appear to reduce the prevalence of psychotropic drug use in community-dwelling elderly people. However, it may prevent concomitant use of psychotropic drugs.

Keywords

medication assessmentantipsychoticantidepressanthypnoticolder people
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 3 , April 2011 , pp. 473 - 484
Copyright
Copyright © International Psychogeriatric Association 2010

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