Research Article
BibTex RIS Cite

Prescription Habits to Geriatric Patients in Psychiatry Clinic- University Hospital and Training and Research Hospital Comparison

Year 2023, Volume: 40 Issue: 3, 609 - 613, 30.09.2023

Abstract

This study aimed to examine the psychotropic drug prescribing habits of clinicians from different clinics for patients over the age of 65 who applied to the psychiatry outpatient clinic. Patients over 65 who applied to the psychiatry outpatient clinic in January 2020 were included in the study. As a result of the inclusion criteria, 523 patients, 241 from university and 282 from training and research hospitals were included in the study. Age, gender, diagnoses, past psychiatric disease histories, and recommended treatments of patients were obtained from electronic files in the hospital automation system. Antidepressant treatment was used in 228 (94.6%) patients in the university hospital and in 232 (82.3%) patients in the training and research hospital (p<0.001). Clinicians preferred monotherapy for 71% (n: 171) of the patients in the university hospital and 56.4% (n: 159) in the training and research hospital (p=0.001). Selective serotonin reuptake inhibitors (SSRI) are the most commonly used antidepressant group in both the university hospital (80.3%) and the training and research hospital (71.5%) (p=0.022). Escitalopram was the most frequently used SSRI in both the university hospital (54.7%) and the training and research hospital (42.8%) (p=0.027). Atypical antipsychotics (96.5%) constituted most antipsychotic preferences in the university hospital and quetiapine (90.9%) among atypicals. Among the antipsychotics, atypical antipsychotics (97.1%) were preferred most frequently in the training and research hospital, and quetiapine (59.4%) was the most common choice among them. The side effect profile is as important as the drug's effectiveness in selecting psychotropic medications in the geriatric period. For this reason, among antidepressants, serotonin reuptake inhibitors, and among antipsychotics, atypical antipsychotics are the first drug groups used.

Supporting Institution

The authors declare that they are not a supporting organization. No funding was used for the study.

Thanks

The authors would like to thank Zeynep Laçiner and İlker Kayı for their contributions and support to this study.

References

  • 1. Available from: http://www.tuik.gov.tr/Start.do.
  • 2. Availablefrom:https://www.merckmanuals.com/professional/geriatrics/approach-to-the-geriatric-patient/introduction-to-geriatrics.
  • 3. Aylan Gımzal Gönentür, Topçuoğlu V. Psikofarmakoterapi: Yaşlı popülasyonda uygulama ilkeleri. Psikiyatride Güncel. 2012;2(4):306-12.
  • 4. O'Mahony D, O'Sullivan D, Byrne S, O'Connor MN, Ryan C, Gallagher P. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age Ageing. 2015;44(2):213-8.
  • 5. Ekşioğlu E, Kesikburun B, Can A, Şimşek Z, Sanman H, Tutal E, et al. An interdisciplinary overview of start/stopp criteria in elderly patients' drug usage: A specialist's perspective. 2016;19:146-53.
  • 6. Rotermann M, Sanmartin C, Hennessy D, Arthur M. Prescription medication use by Canadians aged 6 to 79. Health reports. 2014;25(6):3-9.
  • 7. Tamblyn R, Bates DW, Buckeridge DL, Dixon W, Forster AJ, Girard N, et al. Multinational comparison of new antidepressant use in older adults: a cohort study. BMJ open. 2019;9(5):e027663.
  • 8. Chee KY, Tripathi A, Avasthi A, Chong MY, Sim K, Yang SY, et al. International study on antidepressant prescription pattern at 40 major psychiatric institutions and hospitals in Asia: A 10-year comparison study. Asia-Pacific psychiatry : official journal of the Pacific Rim College of Psychiatrists. 2015;7(4):366-74.
  • 9. Arthur A, Savva GM, Barnes LE, Borjian-Boroojeny A, Dening T, Jagger C, et al. Changing prevalence and treatment of depression among older people over two decades. The British journal of psychiatry : the journal of mental science. 2020;216(1):49-54.
  • 10. Diniz BS, Reynolds CF, 3rd. Major depressive disorder in older adults: benefits and hazards of prolonged treatment. Drugs & aging. 2014;31(9):661-9.
  • 11. Behrman S, Burgess J, Topiwala A. Prescribing antipsychotics in older people: A mini-review. Maturitas. 2018;116:8-10.
  • 12. Schroeck JL, Ford J, Conway EL, Kurtzhalts KE, Gee ME, Vollmer KA, et al. Review of Safety and Efficacy of Sleep Medicines in Older Adults. Clinical therapeutics. 2016;38(11):2340-72.
  • 13. Randle JM, Heckman G, Oremus M, Ho J. Intermittent antipsychotic medication and mortality in institutionalized older adults: A scoping review. International journal of geriatric psychiatry. 2019;34(7):906-20.
  • 14. El-Saifi N, Moyle W, Jones C, Tuffaha H. Quetiapine safety in older adults: a systematic literature review. Journal of clinical pharmacy and therapeutics. 2016;41(1):7-18.
  • 15. Ozen ME, Orum MH, A. K. Evaluation of the Prevalence of Psychiatric Disorders in Geriatric Outpatients: A Difficult Patient Group. Bozok Tıp Dergisi. 2020;10(1):6-12.
  • 16. Yeşil B, Behice HA. Bir Ruh Sağlığı Hastanesi Acil Servisine Başvuran Yaşlı Hastaların Sosyo Demografik ve Klinik Özellikleri. Fırat Tıp Dergisi 2017; 22(3): 113-7.
  • 17. Mark TL, Joish VN, Hay JW, Sheehan DV, Johnston SS, Cao Z. Antidepressant use in geriatric populations: the burden of side effects and interactions and their impact on adherence and costs. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2011;19(3):211-21.
  • 18. Joshi A. Selective Serotonin Re-uptake Inhibitors: An overview. Psychiatria Danubina. 2018;30(Suppl 7):605-9.
  • 19. Topiwala A, Chouliaras L, Ebmeier KP. Prescribing selective serotonin reuptake inhibitors in older age. Maturitas. 2014;77(2):118-23.
  • 20. Viscogliosi G, Donfrancesco C, Lo Noce C, Giampaoli S, Vanuzzo D, Carle F, et al. Association Between Antidepressant Medication Use and Prevalence and Control of Cardiovascular Risk Factors in Community-Dwelling Older Adults: The Italian Health Examination Survey 2008-2012. Metabolic syndrome and related disorders. 2020;18(2):73-8.
  • 21. Nevels RM, Gontkovsky ST, Williams BE. Paroxetine-The Antidepressant from Hell? Probably Not, But Caution Required. Psychopharmacology bulletin. 2016;46(1):77-104.
  • 22. American Geriatrics Society 2019 Updated AGS Beers Criteria(R) for Potentially Inappropriate Medication Use in Older Adults. Journal of the American Geriatrics Society. 2019;67(4):674-94.
  • 23. Glass OM, Hermida AP, Hershenberg R, Schwartz AC. Considerations and Current Trends in the Management of the Geriatric Patient on a Consultation-Liaison Service. Current psychiatry reports. 2020;22(5):21.
  • 24. Cipriani A, Santilli C, Furukawa TA, Signoretti A, Nakagawa A, McGuire H, et al. Escitalopram versus other antidepressive agents for depression. The Cochrane database of systematic reviews. 2009(2):Cd006532.
  • 25. Muijsers RB, Plosker GL, Noble S. Sertraline: a review of its use in the management of major depressive disorder in elderly patients. Drugs & aging. 2002;19(5):377-92.
  • 26. Wiese BS. Geriatric depression: the use of antidepressants in the elderly. BC Med J, 2011, 53.7: 341-347.
  • 27. Gerlach LB, Olfson M, Kales HC, Maust DT. Opioids and Other Central Nervous System-Active Polypharmacy in Older Adults in the United States. Journal of the American Geriatrics Society. 2017;65(9):2052-6.
  • 28. Holland J, Bhogle M. Sertraline and mirtazapine as geriatric antidepressants. Psychiatria Danubina. 2013;25 Suppl 2:S286-90.
  • 29. Khouzam HR. A review of trazodone use in psychiatric and medical conditions. Postgraduate medicine. 2017;129(1):140-8.
Year 2023, Volume: 40 Issue: 3, 609 - 613, 30.09.2023

Abstract

References

  • 1. Available from: http://www.tuik.gov.tr/Start.do.
  • 2. Availablefrom:https://www.merckmanuals.com/professional/geriatrics/approach-to-the-geriatric-patient/introduction-to-geriatrics.
  • 3. Aylan Gımzal Gönentür, Topçuoğlu V. Psikofarmakoterapi: Yaşlı popülasyonda uygulama ilkeleri. Psikiyatride Güncel. 2012;2(4):306-12.
  • 4. O'Mahony D, O'Sullivan D, Byrne S, O'Connor MN, Ryan C, Gallagher P. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age Ageing. 2015;44(2):213-8.
  • 5. Ekşioğlu E, Kesikburun B, Can A, Şimşek Z, Sanman H, Tutal E, et al. An interdisciplinary overview of start/stopp criteria in elderly patients' drug usage: A specialist's perspective. 2016;19:146-53.
  • 6. Rotermann M, Sanmartin C, Hennessy D, Arthur M. Prescription medication use by Canadians aged 6 to 79. Health reports. 2014;25(6):3-9.
  • 7. Tamblyn R, Bates DW, Buckeridge DL, Dixon W, Forster AJ, Girard N, et al. Multinational comparison of new antidepressant use in older adults: a cohort study. BMJ open. 2019;9(5):e027663.
  • 8. Chee KY, Tripathi A, Avasthi A, Chong MY, Sim K, Yang SY, et al. International study on antidepressant prescription pattern at 40 major psychiatric institutions and hospitals in Asia: A 10-year comparison study. Asia-Pacific psychiatry : official journal of the Pacific Rim College of Psychiatrists. 2015;7(4):366-74.
  • 9. Arthur A, Savva GM, Barnes LE, Borjian-Boroojeny A, Dening T, Jagger C, et al. Changing prevalence and treatment of depression among older people over two decades. The British journal of psychiatry : the journal of mental science. 2020;216(1):49-54.
  • 10. Diniz BS, Reynolds CF, 3rd. Major depressive disorder in older adults: benefits and hazards of prolonged treatment. Drugs & aging. 2014;31(9):661-9.
  • 11. Behrman S, Burgess J, Topiwala A. Prescribing antipsychotics in older people: A mini-review. Maturitas. 2018;116:8-10.
  • 12. Schroeck JL, Ford J, Conway EL, Kurtzhalts KE, Gee ME, Vollmer KA, et al. Review of Safety and Efficacy of Sleep Medicines in Older Adults. Clinical therapeutics. 2016;38(11):2340-72.
  • 13. Randle JM, Heckman G, Oremus M, Ho J. Intermittent antipsychotic medication and mortality in institutionalized older adults: A scoping review. International journal of geriatric psychiatry. 2019;34(7):906-20.
  • 14. El-Saifi N, Moyle W, Jones C, Tuffaha H. Quetiapine safety in older adults: a systematic literature review. Journal of clinical pharmacy and therapeutics. 2016;41(1):7-18.
  • 15. Ozen ME, Orum MH, A. K. Evaluation of the Prevalence of Psychiatric Disorders in Geriatric Outpatients: A Difficult Patient Group. Bozok Tıp Dergisi. 2020;10(1):6-12.
  • 16. Yeşil B, Behice HA. Bir Ruh Sağlığı Hastanesi Acil Servisine Başvuran Yaşlı Hastaların Sosyo Demografik ve Klinik Özellikleri. Fırat Tıp Dergisi 2017; 22(3): 113-7.
  • 17. Mark TL, Joish VN, Hay JW, Sheehan DV, Johnston SS, Cao Z. Antidepressant use in geriatric populations: the burden of side effects and interactions and their impact on adherence and costs. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2011;19(3):211-21.
  • 18. Joshi A. Selective Serotonin Re-uptake Inhibitors: An overview. Psychiatria Danubina. 2018;30(Suppl 7):605-9.
  • 19. Topiwala A, Chouliaras L, Ebmeier KP. Prescribing selective serotonin reuptake inhibitors in older age. Maturitas. 2014;77(2):118-23.
  • 20. Viscogliosi G, Donfrancesco C, Lo Noce C, Giampaoli S, Vanuzzo D, Carle F, et al. Association Between Antidepressant Medication Use and Prevalence and Control of Cardiovascular Risk Factors in Community-Dwelling Older Adults: The Italian Health Examination Survey 2008-2012. Metabolic syndrome and related disorders. 2020;18(2):73-8.
  • 21. Nevels RM, Gontkovsky ST, Williams BE. Paroxetine-The Antidepressant from Hell? Probably Not, But Caution Required. Psychopharmacology bulletin. 2016;46(1):77-104.
  • 22. American Geriatrics Society 2019 Updated AGS Beers Criteria(R) for Potentially Inappropriate Medication Use in Older Adults. Journal of the American Geriatrics Society. 2019;67(4):674-94.
  • 23. Glass OM, Hermida AP, Hershenberg R, Schwartz AC. Considerations and Current Trends in the Management of the Geriatric Patient on a Consultation-Liaison Service. Current psychiatry reports. 2020;22(5):21.
  • 24. Cipriani A, Santilli C, Furukawa TA, Signoretti A, Nakagawa A, McGuire H, et al. Escitalopram versus other antidepressive agents for depression. The Cochrane database of systematic reviews. 2009(2):Cd006532.
  • 25. Muijsers RB, Plosker GL, Noble S. Sertraline: a review of its use in the management of major depressive disorder in elderly patients. Drugs & aging. 2002;19(5):377-92.
  • 26. Wiese BS. Geriatric depression: the use of antidepressants in the elderly. BC Med J, 2011, 53.7: 341-347.
  • 27. Gerlach LB, Olfson M, Kales HC, Maust DT. Opioids and Other Central Nervous System-Active Polypharmacy in Older Adults in the United States. Journal of the American Geriatrics Society. 2017;65(9):2052-6.
  • 28. Holland J, Bhogle M. Sertraline and mirtazapine as geriatric antidepressants. Psychiatria Danubina. 2013;25 Suppl 2:S286-90.
  • 29. Khouzam HR. A review of trazodone use in psychiatric and medical conditions. Postgraduate medicine. 2017;129(1):140-8.
There are 29 citations in total.

Details

Primary Language English
Subjects Clinical Pharmacology and Therapeutics, Geriatrics and Gerontology, Psychiatry
Journal Section Research Article
Authors

Kerem Laçiner 0000-0001-8253-7933

Selçuk Özdin 0000-0003-1127-1132

Early Pub Date October 6, 2023
Publication Date September 30, 2023
Submission Date July 30, 2023
Acceptance Date August 22, 2023
Published in Issue Year 2023 Volume: 40 Issue: 3

Cite

APA Laçiner, K., & Özdin, S. (2023). Prescription Habits to Geriatric Patients in Psychiatry Clinic- University Hospital and Training and Research Hospital Comparison. Journal of Experimental and Clinical Medicine, 40(3), 609-613.
AMA Laçiner K, Özdin S. Prescription Habits to Geriatric Patients in Psychiatry Clinic- University Hospital and Training and Research Hospital Comparison. J. Exp. Clin. Med. September 2023;40(3):609-613.
Chicago Laçiner, Kerem, and Selçuk Özdin. “Prescription Habits to Geriatric Patients in Psychiatry Clinic- University Hospital and Training and Research Hospital Comparison”. Journal of Experimental and Clinical Medicine 40, no. 3 (September 2023): 609-13.
EndNote Laçiner K, Özdin S (September 1, 2023) Prescription Habits to Geriatric Patients in Psychiatry Clinic- University Hospital and Training and Research Hospital Comparison. Journal of Experimental and Clinical Medicine 40 3 609–613.
IEEE K. Laçiner and S. Özdin, “Prescription Habits to Geriatric Patients in Psychiatry Clinic- University Hospital and Training and Research Hospital Comparison”, J. Exp. Clin. Med., vol. 40, no. 3, pp. 609–613, 2023.
ISNAD Laçiner, Kerem - Özdin, Selçuk. “Prescription Habits to Geriatric Patients in Psychiatry Clinic- University Hospital and Training and Research Hospital Comparison”. Journal of Experimental and Clinical Medicine 40/3 (September 2023), 609-613.
JAMA Laçiner K, Özdin S. Prescription Habits to Geriatric Patients in Psychiatry Clinic- University Hospital and Training and Research Hospital Comparison. J. Exp. Clin. Med. 2023;40:609–613.
MLA Laçiner, Kerem and Selçuk Özdin. “Prescription Habits to Geriatric Patients in Psychiatry Clinic- University Hospital and Training and Research Hospital Comparison”. Journal of Experimental and Clinical Medicine, vol. 40, no. 3, 2023, pp. 609-13.
Vancouver Laçiner K, Özdin S. Prescription Habits to Geriatric Patients in Psychiatry Clinic- University Hospital and Training and Research Hospital Comparison. J. Exp. Clin. Med. 2023;40(3):609-13.