OBJECTIVES: the study aimed to examine the prevalence of comorbidity, the prescribing of potentially inappropriate medications and treatment conflicts in a large sample of older people who have been dispensed an antidepressant medicine. METHODS: a cross-sectional study of administrative claims data from the Department of Veterans' Affairs, Australia, 1 April-31 July 2007, of veterans aged > or =65 years was conducted. Comorbidities determined using the pharmaceutical-based comorbidity index, Rx-Risk-V. Concomitant medicines that may be potentially inappropriate for patients with depression and areas of treatment conflicts were determined from Australian clinical guidelines or reference compendia. RESULTS: a total of 39,695 subjects were included, with a median of 5 comorbid conditions (inter-quartile range 3-6). Ninety percent of medicine use was attributed to the treatment of comorbid conditions. Eighty-seven percent of the study cohort was identified as having at least one comorbid condition that may cause a potential treatment conflict when an antidepressant is used. Those conditions of most concern included cardiovascular diseases, anxiety disorders, arthritis or pain management and osteoporosis. CONCLUSION: we observed a high level of potentially inappropriate prescribing and treatment conflicts that may arise when caring for older patients dispensed an antidepressant with comorbidity. These have the potential to place a large number of older people with depression at increased risk for adverse events.
OBJECTIVES: the study aimed to examine the prevalence of comorbidity, the prescribing of potentially inappropriate medications and treatment conflicts in a large sample of older people who have been dispensed an antidepressant medicine. METHODS: a cross-sectional study of administrative claims data from the Department of Veterans' Affairs, Australia, 1 April-31 July 2007, of veterans aged > or =65 years was conducted. Comorbidities determined using the pharmaceutical-based comorbidity index, Rx-Risk-V. Concomitant medicines that may be potentially inappropriate for patients with depression and areas of treatment conflicts were determined from Australian clinical guidelines or reference compendia. RESULTS: a total of 39,695 subjects were included, with a median of 5 comorbid conditions (inter-quartile range 3-6). Ninety percent of medicine use was attributed to the treatment of comorbid conditions. Eighty-seven percent of the study cohort was identified as having at least one comorbid condition that may cause a potential treatment conflict when an antidepressant is used. Those conditions of most concern included cardiovascular diseases, anxiety disorders, arthritis or pain management and osteoporosis. CONCLUSION: we observed a high level of potentially inappropriate prescribing and treatment conflicts that may arise when caring for older patients dispensed an antidepressant with comorbidity. These have the potential to place a large number of older people with depression at increased risk for adverse events.
Authors: Richard Ofori-Asenso; Jenni Ilomäki; Mark Tacey; Si Si; Andrea J Curtis; Ella Zomer; J Simon Bell; Sophia Zoungas; Danny Liew Journal: Br J Clin Pharmacol Date: 2018-11-08 Impact factor: 4.335
Authors: Greta A Bushnell; Til Stürmer; Bradley N Gaynes; Virginia Pate; Matthew Miller Journal: JAMA Psychiatry Date: 2017-07-01 Impact factor: 21.596
Authors: Wendy Moyle; Najwan El Saifi; Brian Draper; Cindy Jones; Elizabeth Beattie; David Shum; Lukman Thalib; Cindy Mervin; Siobhan O Dwyer Journal: Curr Drug Saf Date: 2017-02-09
Authors: Tanisha Jowsey; Ian S McRae; Jose M Valderas; Paul Dugdale; Rebecca Phillips; Robin Bunton; James Gillespie; Michelle Banfield; Lesley Jones; Marjan Kljakovic; Laurann Yen Journal: PLoS One Date: 2013-04-01 Impact factor: 3.240