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Prevalence and characteristics of antidepressant drug prescriptions in older Italian patients

Published online by Cambridge University Press:  08 December 2011

A. Marengoni ,
G. Bianchi ,
A. Nobili ,
M. Tettamanti ,
L. Pasina ,
S. Corrao ,
F. Salerno ,
A. Iorio ,
M. Marcucci  and
P. M. Mannucci
A. Marengoni*
Affiliation:
Geriatric Unit, Spedali Civili, Department of Medical and Surgery Sciences, University of Brescia, Brescia, Italy
G. Bianchi
Affiliation:
Geriatric Unit, Spedali Civili, Department of Medical and Surgery Sciences, University of Brescia, Brescia, Italy
A. Nobili
Affiliation:
Department of Neuroscience, Mario Negri Institute for Pharmacological Research, Milan, Italy
M. Tettamanti
Affiliation:
Department of Neuroscience, Mario Negri Institute for Pharmacological Research, Milan, Italy
L. Pasina
Affiliation:
Department of Neuroscience, Mario Negri Institute for Pharmacological Research, Milan, Italy
S. Corrao
Affiliation:
Biomedical Department of Internal and Specialist Medicine, University of Palermo, Palermo, Italy
F. Salerno
Affiliation:
Internal Medicine, IRCCS Policlinic San Donato, Department of Medical and Surgery Sciences, University of Milano, Milan, Italy
A. Iorio
Affiliation:
Department of Internal Medicine, University of Perugia, Perugia, Italy
M. Marcucci
Affiliation:
Department of Internal Medicine, University of Perugia, Perugia, Italy
P. M. Mannucci
Affiliation:
IRCCS Maggiore Hospital Foundation, Milan, Italy
*
Correspondence should be addressed to: Alessandra Marengoni, MD, PhD, Geriatric Unit, Spedali Civili, Department of Medical and Surgery Sciences, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy. Phone: +39-030-2528340; Fax: +39-030-396011. Email: [email protected].
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Abstract

Background: During last few decades, the proportion of elderly persons prescribed with antidepressants for the treatment of depression and anxiety has increased. The aim of this study was to evaluate prevalence of antidepressant prescription and related factors in elderly in-patients, as well as the consistency between prescription of antidepressants and specific diagnoses requiring these medications.

Methods: Thirty-four internal medicine and four geriatric wards in Italy participated in the Registro Politerapie SIMI–REPOSI study during 2008. In all, 1,155 in-patients, 65 years or older, were enrolled. Prevalence of the use of antidepressants was calculated at both admission and discharge. Logistic regression was used to evaluate the association between patients’ characteristics (age, gender, Charlson Index, number of drugs, specific diseases, other psychotropic medications) and the prescription of antidepressants.

Results: The number of patients treated with antidepressant medication at hospital admission was 115 (9.9%) and at discharge 119 (10.3%). In a multivariate analysis, a higher number of drugs (OR = 1.2; 95% CI = 1.1–1.3), use of anxiolytic drugs (OR = 2.1; 95% CI = 1.2–3.6 and OR = 3.8; 95% CI = 2.1–6.8), and a diagnosis of dementia (OR = 6.1; 95% CI = 3.1–11.8 and OR = 5.8; 95% CI = 3.3–10.3, respectively, at admission and discharge) were independently associated with antidepressant prescription. A specific diagnosis requiring the use of antidepressants was present only in 66 (57.4%) patients at admission and 76 (66.1%) at discharge.

Conclusions: Antidepressants are commonly prescribed in geriatric patients, especially in those receiving multiple drugs, other psychotropic drugs, and those affected by dementia. There is an inconsistency between the prescription of antidepressants and a specific diagnosis that the hospitalization only slightly improves.

Keywords

antidepressantsprescriptionelderlyhospitalizationdementia
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 4 , April 2012 , pp. 606 - 613
Copyright
Copyright © International Psychogeriatric Association 2011

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References

Alexopoulos, G. S., Buckwalter, K., Olin, J., Martinez, R., Wainscott, C. and Krishnan, K. R. (2002). Comorbidity of late life depression: an opportunity for research on mechanism and treatment. Biological Psychiatry, 52, 543–558.Google Scholar
Arve, S., Tilvis, R. S., Lehtonen, A., Valvanne, J. and Sairanen, S. (1999). Coexistence of lowered mood and cognitive impairment of elderly people in five birth cohorts. Aging (Milano), 11, 90–95.Google Scholar
Caughey, G. E., Roughead, E. E., Shakib, S., McDermott, R. A., Vitry, A. I. and Gilbert, A. L. (2010). Comorbidity of chronic disease and potential treatment conflicts in older people dispensed antidepressants. Age and Ageing, 39, 488–494.CrossRefGoogle ScholarPubMed
Charlson, M. E., Pompei, P., Ales, K. L. and MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of Chronic Diseases, 40, 373–383.CrossRefGoogle ScholarPubMed
Covinsky, K. E., Kahana, E., Chin, M. H., Palmer, R. M., Fortinsky, R. H. and Landefeld, C. S. (1999). Depressive symptoms and 3-year mortality in older hospitalized medical patients. Annals of Internal Medicine, 130, 563–569.Google Scholar
Dolder, C., Nelson, M. and Stump, A. (2010). Pharmacological and clinical profile of newer antidepressants: implications for the treatment of elderly patients. Drugs and Aging, 27, 625–640.CrossRefGoogle ScholarPubMed
Henry, G, Williamson, D. and Tampi, R. R. (2011). Efficacy and tolerability of antidepressants in the treatment of behavioral and psychological symptoms of dementia: a literature review of evidence. American Journal of Alzheimer's Disease and Other Dementias, 26, 169–183.Google Scholar
Koenig, H. G. and George, L. K. (1998). Depression and physical disability outcomes in depressed medically ill hospitalized older adults. American Journal of Geriatric Psychiatry, 6, 230–247.CrossRefGoogle ScholarPubMed
Meyers, B. S. (1998) Depression and dementia: comorbidities, identification, and treatment. Journal of Geriatric Psychiatry and Neurology, 11, 201–205.CrossRefGoogle ScholarPubMed
Meyers, B. S. and Jeste, D. V. (2010). Geriatric Psychopharmacology: evolution of a discipline. Journal of Clinical Psychiatry, 71, 1416–1424.Google Scholar
Moussavi, S., Chatterji, S., Verdes, E., Tandon, A., Patel, V. and Ustun, B. (2007). Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet, 370, 851–858.Google Scholar
Parabiaghi, A. et al. (2011). Antidepressants utilization among elderly in Lombardy from 2000 to 2007: dispensing trends and appropriateness. European Journal of Clinical Pharmacology, 67, 1077–1083.CrossRefGoogle ScholarPubMed
Pincus, H. A. et al. (1998). Prescribing trends in psychotropic medications: primary care, psychiatry, and other medical specialties. JAMA, 279, 526–531.Google Scholar
Prince, M. et al. (2007). No health without mental health. Lancet, 370, 859–877.CrossRefGoogle ScholarPubMed
Ray, W. A., Tharpa, P. B. and Gideon, P. (2000) Benzodiazepines and the risk of falls in nursing home residents. Journal of the American Geriatrics Society, 48, 682–685.CrossRefGoogle ScholarPubMed
Rosenberg, P. B. et al. for the DIADS-2 Research Group (2010). Sertraline for the treatment of depression in Alzheimer disease. American Journal of Geriatric Psychiatry, 18, 136–145.Google Scholar
Schweitzer, I. and Tuckwell, V. (1998). Risk of adverse events with the use of augmentation therapy for the treatment of resistant depression. Drug Safety, 19, 455–464.CrossRefGoogle ScholarPubMed
Seitz, D. P., Gill, S. S. and Conn, D. K. (2010). Citalopram versus other antidepressants for late-life depression: a systematic review and meta-analysis. International Journal of Geriatric Psychiatry, 25, 1296–1305.Google Scholar
Simonson, W. and Feinberg, J. L. (2005). Medication-related problems in the elderly: defining the issue and identifying solutions. Drugs and Aging, 22, 559–569.Google Scholar
Stitt, D. M., Elliott, D. P. and Thompson, S. N. (2011). Medication discrepancies identified at time of hospital discharge in a geriatric population. American Journal of Geriatric Pharmacotherapy, 9, 234–240.Google Scholar
Wolitzky-Taylor, K. B., Castriotta, N., Lenze, E. J., Stanley, M. A. and Craske, M. G. (2010). Anxiety disorders in older adults: a comprehensive review. Depression and Anxiety, 27, 190–211.CrossRefGoogle ScholarPubMed
World Health Organization (1987). International Classification of Diseases, Injuries, and Causes of Death. Ninth Revision (ICD-9).Geneva: WHO.Google Scholar
World Health Organization (1990). Guidelines for ATC Classification. Oslo: WHO. Collaborating Centre for Drug Statistics Methodology, Norway and Nordic Councils on Medicines.Google Scholar