Extent and Predictors of Potentially Inappropriate Antidepressant Use Among Older Adults With Dementia and Major Depressive Disorder

Bhattacharjee, Sandipan; Lee, Jeannie K.; Patanwala, Asad E.; Vadiei, Nina; Malone, Daniel C.; Knapp, Shannon M.; Lo-Ciganic, Wei Hsuan; Burke, William J.

doi:10.1016/j.jagp.2019.02.002

Cited by 9 publications

(8 citation statements)

References 42 publications

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“…A p -value of <0.05 was considered statistically significant. In all analyses, we used adults with dementia as the reference group, because dementia is a highly disabling disease and often coexist with chronic mental and physical conditions that require multiple treatments ( Bhattacharjee et al, 2019 , Prince et al, 2014 ).…”

Section: Research Methods and Designmentioning

confidence: 99%

Evaluation of psychotropic medications use among elderly with psychiatric disorders in Saudi Arabia

Meraya

Banji

Khobrani

et al. 2021

Saudi Pharmaceutical Journal

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Aims Potentially inappropriate psychotropic medications (PIPMs) prescribed to older adults with psychiatric disorders can inadvertently affect their health. The use of standards and guidelines can ensure prudent prescribing and minimize the risk of morbidities. This study assessed the pattern and prevalence of prescription of PIPMs to older individuals in outpatient psychiatric settings in Saudi Arabia, using the updated 2015 Beers criteria, as well as the probability of polypharmacy. Methods The study was conducted in the outpatient psychiatric clinics of the only psychiatric hospital in Jazan region of Saudi Arabia. A retrospective cross-sectional review of electronic medical records was undertaken during 2018 to assess PIPM use and psychotropic polypharmacy. Descriptive statistics were generated and associations between PIPM use and baseline characteristics were assessed using multivariable logistic regression. Results Overall, 68% of 1300 older adults received PIPMs, and 77.7% were on psychotropic polypharmacy. Amitriptyline, chlorpromazine, and trifluoperazine were extensively prescribed. Paroxetine (1.2%) and benzodiazepines were prescribed to a smaller proportion of the patients. Elderly with schizophrenia (AOR = 0.046, p < 0.001) and anxiety (AOR = 0.530, p = 0.036) were significantly less likely to have PIPMs than those with dementia. Likewise, elderly with depression and anxiety were less likely to have psychotropic polypharmacy as compared to those with dementia. Conclusion A substantial number of the elderly received PIPMs possibly based on implicit criteria. It is therefore important to provide mental health care providers in the region with educational programs to increase their awareness of PIPMs.

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Section: Research Methods and Designmentioning

confidence: 99%

Evaluation of psychotropic medications use among elderly with psychiatric disorders in Saudi Arabia

Meraya

Banji

Khobrani

et al. 2021

Saudi Pharmaceutical Journal

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“…44 Furthermore, a recent study by our research team that evaluated the appropriateness of antidepressant selection for the older population having dementia and depression found almost equivalent rates of inappropriate antidepressant initiation between White subjects (7.6%) and their non-White counterparts (7.5%). 22 Although race/ethnicity did not differ between inappropriate and appropriate antidepressants initiated by the study sample in our previous study, 22 we know that not as many minority older patients are initiated on an antidepressant; thus, the similar rate of inappropriate prescribing was an unfortunate finding.…”

Section: Discussionmentioning

confidence: 60%

“…24,25 This list of potentially inappropriate antidepressants has been used in our previous study. 22 Antidepressants that were included in this study based on the HEDIS guidelines are presented in Appendix 1. Antidepressants were identified using the National Drug Codes available from the PDE file.…”

Section: Dependent Variablesmentioning

confidence: 99%

“…Currently, there are no depression treatment guidelines for older adults with dementia and MDD. In one of our previous studies, 22 we quantified the extent of potentially inappropriate antidepressants among older adults with dementia and newly diagnosed MDD using the National Committee for Quality Assurance's (NCQA's) Healthcare Effectiveness Data and Information Set (HEDIS) guidelines for antidepressant medication management (AMM). 23 A list of potentially inappropriate antidepressants for older adults with dementia in our recently published study 22 was developed using the Beers criteria and Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria.…”

Section: Introductionmentioning

confidence: 99%

“…In one of our previous studies, 22 we quantified the extent of potentially inappropriate antidepressants among older adults with dementia and newly diagnosed MDD using the National Committee for Quality Assurance's (NCQA's) Healthcare Effectiveness Data and Information Set (HEDIS) guidelines for antidepressant medication management (AMM). 23 A list of potentially inappropriate antidepressants for older adults with dementia in our recently published study 22 was developed using the Beers criteria and Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria. 24,25 Given the evidence supporting the potential benefits of depression treatment and the serious lack of studies examining adherence to depression treatment among older adults with dementia and newly diagnosed MDD, there is a need to examine the status of depression treatment adherence in this vulnerable population.…”

Section: Introductionmentioning

confidence: 99%

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<p>Extent and Factors Associated with Adherence to Antidepressant Treatment During Acute and Continuation Phase Depression Treatment Among Older Adults with Dementia and Major Depressive Disorder</p>

Bhattacharjee

Lee

Vadiei

et al. 2020

NDT

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Purpose: Little is known about adherence to antidepressant treatment during acute and continuation phase of depression among older adults with dementia and newly diagnosed major depressive disorders (MDD). This study estimated the extent of and factors associated with adherence to acute and continuation phase antidepressant treatment among older adults with dementia and newly diagnosed MDD. Methods: We conducted a retrospective cohort study using the Medicare 5% sample claims data (2012-2013) among older adults (age≥65 years) with dementia who were newly diagnosed with MDD. Intake period of our study was from 01-May-2012 through 30-April-2013. The dependent variables of this study were acute and continuation phase depression treatment adherence. Factors associated with acute and continuation phase antidepressant treatment adherence were identified using multiple logistic regression analyses. Results: The final study sample consisted of 6239 [adherent: N=4644 (74.44%)] and 5617 [adherent: N=3584 (63.81%)] older adults with dementia and MDD during the acute and continuation phase treatment, respectively. During the acute phase, only race/ethnicity was significantly associated with adherence to depression treatment, whereas race/ethnicity and baseline antipsychotic use were significantly associated with adherence to depression treatment during the continuation phase. Conclusion: Approximately, 74% and 64% older adults with dementia and MDD were adherent to acute and continuation phase antidepressant treatment in this nationally representative sample of Medicare beneficiaries, and we identified several modifiable and nonmodifiable factors associated with adherence.

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Mild Neurocognitive Disorders

Ratnakaran,

Jan,

Raelly-Muze

et al. 2024

Treatment of Psychiatric Disorders Among Older Adults

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Extent and Predictors of Potentially Inappropriate Antidepressant Use Among Older Adults With Dementia and Major Depressive Disorder

Cited by 9 publications

References 42 publications

Evaluation of psychotropic medications use among elderly with psychiatric disorders in Saudi Arabia

Evaluation of psychotropic medications use among elderly with psychiatric disorders in Saudi Arabia

<p>Extent and Factors Associated with Adherence to Antidepressant Treatment During Acute and Continuation Phase Depression Treatment Among Older Adults with Dementia and Major Depressive Disorder</p>

Mild Neurocognitive Disorders

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