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Change in psychotropic drug use among community-dwelling people aged 75 years and older in Finland: repeated cross-sectional population studies

Published online by Cambridge University Press:  19 April 2011

Franciska Desplenter ,
Charlotte Caenen ,
Jolein Meelberghs ,
Sirpa Hartikainen ,
Raimo Sulkava  and
J. Simon Bell
Franciska Desplenter
Affiliation:
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland Clinical Pharmacology and Geriatric Pharmacotherapy Unit, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland Research Centre for Pharmaceutical Care and Pharmaco-economics, Faculty of Pharmaceutical Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
Charlotte Caenen
Affiliation:
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland Research Centre for Pharmaceutical Care and Pharmaco-economics, Faculty of Pharmaceutical Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
Jolein Meelberghs
Affiliation:
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland Research Centre for Pharmaceutical Care and Pharmaco-economics, Faculty of Pharmaceutical Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
Sirpa Hartikainen
Affiliation:
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland Clinical Pharmacology and Geriatric Pharmacotherapy Unit, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland Leppävirta Health Center, Leppävirta, 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
J. Simon Bell*
Affiliation:
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland Clinical Pharmacology and Geriatric Pharmacotherapy Unit, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland Quality Use of Medicines and Pharmacy Research Center, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
*
Correspondence should be addresed to: J. Simon Bell, PhD, Research Director, Kuopio Research Center of Geriatric Care, PO Box 1627, University of Eastern Finland, Kuopio 70211, Finland. Phone: +358 403553266; Fax: +358 17162424. Email: simon.bell@uef.fi.
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Abstract

Background: Older people are at high risk of experiencing psychotropic-related adverse drug events. The objective of this study was to compare and contrast the use of psychotropic drugs among community-dwelling people aged ≥75 years in 1998 and 2004.

Methods: Comparable random samples of people aged ≥75 years were extracted from the population register in Kuopio, Finland, in 1998 (n = 700) and 2003 (n = 1000). In 1998 and 2004, 523 and 700 community-dwelling people respectively participated in nurse interviews, during which demographic, diagnostic and drug use data were elicited. Logistic regression was used to compute unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the prevalence of psychotropic drug use in 2004 compared to 1998.

Results: The unadjusted prevalence of total psychotropic (37.3% and 38.4%, OR 1.05; 95% CI 0.83–1.33), anxiolytic, hypnotic and sedative (29.6% and 31.3%, OR 1.08, 95% CI 0.85–1.38), and antidepressant (10.7% and 11.9%, OR 1.12, 95% CI 0.78–1.61) use were similar in 1998 and 2004. There was a decrease in the unadjusted prevalence of antipsychotic use (9.2% and 5.7%, OR 0.60; 95% CI 0.39–0.93). After adjusting for socioeconomic and health status differences, there was an increase in the prevalence of total psychotropic (adjusted OR 1.31, 95% CI 1.01–1.70) and antidepressant (OR 1.59, 95% CI 1.06–2.40) use.

Conclusion: The unadjusted prevalence of psychotropic drug use remained stable between 1998 and 2004. However, in adjusted analyses there was a small increase in the prevalence of any psychotropic drug use and antidepressant use specifically.

Keywords

psychotropic drugsagedcommunity-health servicesFinland
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 8 , October 2011 , pp. 1278 - 1284
Copyright
Copyright © International Psychogeriatric Association 2011

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References

Aparasu, R. R., Mort, J. R. and Brandt, H. (2003). Psychotropic prescription use by community-dwelling elderly in the United States. Journal of the American Geriatrics Society, 51, 671–677.CrossRefGoogle ScholarPubMed
Bell, J. S., Väänänen, M., Ovaskainen, H., Närhi, U. and Airaksinen, M. S. (2007). Providing patient care in community pharmacies: practice and research in Finland. Annals of Pharmacotherapy, 41, 1039–1046.CrossRefGoogle ScholarPubMed
Bell, J. S., Klaukka, T., Ahonen, J. and Hartikainen, S. (2009). National utilization of transdermal fentanyl among community-dwelling older people in Finland. American Journal of Geriatric Pharmacotherapy, 7, 355–361.CrossRefGoogle ScholarPubMed
Dorsey, E. R., Rabbani, A., Gallagher, S. A., Conti, R. M. and Alexander, G. C. (2010). Impact of FDA black box advisory on antipsychotic medication use. Archives of Internal Medicine, 170, 96–103.CrossRefGoogle ScholarPubMed
Draper, B. and Berman, K. (2008). Tolerability of selective serotonin reuptake inhibitors: issues relevant to the elderly. Drugs and Aging, 25, 501–519.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Fox, C. B., Treadway, A. K., Blaszczyk, A. T. and Sleeper, R. B. (2009). Megestrol acetate and mirtazapine for the treatment of unplanned weight loss in the elderly. Pharmacotherapy, 29, 383–397.CrossRefGoogle ScholarPubMed
Hartikainen, S., Rahkonen, T., Kautianen, H. and Sulkava, R. (2003). Kuopio 75+ study: does advanced age predict more common use of psychotropics among the elderly? International Clinical Psychopharmacology, 18, 163–167.Google ScholarPubMed
Hartikainen, S. A., Mantyselka, P., Louhivuori-Laako, K., Enlund, H. and Sulkava, R. (2005). Concomitant use of analgesics and psychotropics in home-dwelling elderly people – Kuopio 75+ study. British Journal of Clinical Pharmacology, 60, 306–310.CrossRefGoogle ScholarPubMed
Hartikainen, S., Lönnroos, E. and Louhivuori, K. (2007). Medication as a risk factor for falls: critical systematic review. Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 62, 1172–1181.CrossRefGoogle ScholarPubMed
Hilmer, S. N., McLachlan, A. J. and Le Couteur, D. G. (2007). Clinical pharmacology in the geriatric patient. Fundamental and Clinical Pharmacology, 21, 217–230.CrossRefGoogle ScholarPubMed
Jyrkkä, J., Enlund, H., Korhonen, M. J., Sulkava, R. and Hartikainen, S. (2009). Patterns of drug use and factors associated with polypharmacy and excessive polypharmacy in elderly persons: results of the Kuopio 75+ study: a cross-sectional analysis. Drugs and Aging, 26, 494–503.CrossRefGoogle ScholarPubMed
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.CrossRefGoogle ScholarPubMed
Linjakumpu, T. A., Hartikainen, S. A., Klaukka, T. J., Koponen, H. J., Kivela, S-L. and Isoaho, R. E. (2002). Psychotropics among the home dwelling elderly: increasing trends. International Journal of Geriatric Psychiatry, 17, 874–883.CrossRefGoogle ScholarPubMed
National Agency for Medicines and Social Insurance Institution of Finland (2009) Finnish Statistics on Medicines. Available at: www.nam.fi/medicines/drug_consumption/finnish_statistics_on_medicines; last accessed 9 March 2011.Google Scholar
O'Bryant, S. E. et al. (2008). Detecting dementia with the mini-mental state examination in highly educated individuals. Archives of Neurology, 65, 963–967.Google ScholarPubMed
Pokela, N., Bell, J. S., Lihavainen, K., Sulkava, R. and Hartikainen, S. (2010). Analgesic use among community-dwelling people aged 75 years and older: a population-based interview study. American Journal of Geriatric Pharmacotherapy, 8, 233–244.CrossRefGoogle Scholar
Rikala, M., Hartikainen, S., Sulkava, R. and Korhonen, M. J. (2010a). Validity of the Finnish Prescription Register for measuring psychotropic drug exposures among elderly Finns: a population-based intervention study. Drugs and Aging, 27, 337–349.CrossRefGoogle ScholarPubMed
Rikala, M., Korhonen, M. J., Sulkava, R. and Hartikainen, S. (2010b). The effects of medication assessment on psychotropic drug use in the community-dwelling elderly. International Psychogeriatrics, 23, 473–484.CrossRefGoogle ScholarPubMed
Salonoja, M., Salminen, M., Aarnio, P., Vahlberg, T. and Kivelä, S. L. (2010). One-time counselling decreases the use of benzodiazepines and related drugs among community-dwelling older persons. Age and Ageing, 39, 313–319.CrossRefGoogle ScholarPubMed
Schneider, L. S. et al. (2006). Effectiveness of atypical antipsychotic drugs in patients with Alzheimer's disease. New England Journal of Medicine, 355, 1525–1538.CrossRefGoogle ScholarPubMed
Snowdon, J. and Fleming, R. (2008). Recognising depression in residential facilities: an Australian challenge. International Journal of Geriatric Psychiatry, 23, 295–300.CrossRefGoogle ScholarPubMed
Sonnenberg, C. M., Deeg, D. J., Comijs, H. C., van Tilburg, W. and Beekman, A. T. (2008). Trends in antidepressant use in the older population: results from the LASA-study over a period of 10 years. Journal of Affective Disorders, 211, 299–305.CrossRefGoogle Scholar
Soudry, A., Dufouil, C., Ritchie, K., Dartigues, J. F., Tzourio, C. and Alpérovitch, A. (2008). Factors associated with changes in antidepressant use in a community-dwelling elderly cohort: the Three-City Study. European Journal of Clinical Pharmacology, 64, 51–59.CrossRefGoogle Scholar
van Vliet, P., van der Mast, R. C., van den Broek, M., Westendorp, R. G. and de Craen, A. J. (2009). Use of benzodiazepines, depressive symptoms and cognitive function in old age. International Journal of Geriatric Psychiatry, 24, 500–508.CrossRefGoogle ScholarPubMed
Verdoux, H., Tournier, M. and Bégaud, B. (2010). Antipsychotic prescribing trends: a review of pharmaco-epidemiological studies. Acta Psychiatrica Scandinavica, 121, 4–10.CrossRefGoogle ScholarPubMed
Watanabe, N. et al. (2010). Safety reporting and adverse-event profile of mirtazapine described in randomized controlled trials in comparison with other classes of antidepressants in the acute-phase treatment of adults with depression: systematic review and meta-analysis. CNS Drugs, 24, 35–53.CrossRefGoogle ScholarPubMed
Yesavage, J. A. et al. (1982–1983). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 37–49.CrossRefGoogle Scholar
Zhang, Y. et al. (2010). Antidepressant use and depressive symptomatology among older people from the Australian Longitudinal Study of Ageing. International Psychogeriatrics, 22, 437–444.CrossRefGoogle ScholarPubMed