BACKGROUND: The study evaluated the effects of an annual medication assessment conducted as part of a Comprehensive Geriatric Assessment (CGA) on the prevalence of psychotropic drug use in community-dwelling elderly people. METHODS:Randomly selected persons (n = 1000) aged ≥75 years living in the city of Kuopio, Finland were randomized to intervention and control groups. The intervention group underwent an annual (2004-2006) medication assessment as part of a CGA by physicians. Data on drug use were gathered by interviews at baseline (2004) and in three following years (2005-2007). Generalized estimating equations (GEE) were applied to explore whether the prevalence of psychotropic drug use differed between the community-dwelling participants of the intervention (n = 361) and control groups (n = 339) over time. RESULTS: At baseline, nearly 40% of the participants used psychotropic drugs in each group. In the intervention group, the study physicians implemented 126 psychotropic drug-related changes, 39% of which were persistent after one year. The prevalence of use of psychotropic drugs, antipsychotics and anxiolytic/hypnotics did not differ between the groups over time. The prevalence of antidepressant use remained constant in the intervention group, but increased in the control group (p-value for interaction = 0.039). The prevalence of concomitant use of psychotropic drugs decreased non-significantly in the intervention group, but increased in the control group (p-value for interaction = 0.009). CONCLUSIONS: Conducting an annual medication assessment outside the usual primary health care system does not appear to reduce the prevalence of psychotropic drug use in community-dwelling elderly people. However, it may prevent concomitant use of psychotropic drugs.
RCT Entities:
BACKGROUND: The study evaluated the effects of an annual medication assessment conducted as part of a Comprehensive Geriatric Assessment (CGA) on the prevalence of psychotropic drug use in community-dwelling elderly people. METHODS: Randomly selected persons (n = 1000) aged ≥75 years living in the city of Kuopio, Finland were randomized to intervention and control groups. The intervention group underwent an annual (2004-2006) medication assessment as part of a CGA by physicians. Data on drug use were gathered by interviews at baseline (2004) and in three following years (2005-2007). Generalized estimating equations (GEE) were applied to explore whether the prevalence of psychotropic drug use differed between the community-dwelling participants of the intervention (n = 361) and control groups (n = 339) over time. RESULTS: At baseline, nearly 40% of the participants used psychotropic drugs in each group. In the intervention group, the study physicians implemented 126 psychotropic drug-related changes, 39% of which were persistent after one year. The prevalence of use of psychotropic drugs, antipsychotics and anxiolytic/hypnotics did not differ between the groups over time. The prevalence of antidepressant use remained constant in the intervention group, but increased in the control group (p-value for interaction = 0.039). The prevalence of concomitant use of psychotropic drugs decreased non-significantly in the intervention group, but increased in the control group (p-value for interaction = 0.009). CONCLUSIONS: Conducting an annual medication assessment outside the usual primary health care system does not appear to reduce the prevalence of psychotropic drug use in community-dwelling elderly people. However, it may prevent concomitant use of psychotropic drugs.
Authors: Carolyn T Thorpe; Holly C Lassila; Christine K O'Neil; Joshua M Thorpe; Joseph T Hanlon; Robert L Maher Journal: Am J Geriatr Pharmacother Date: 2012-02
Authors: Marie H Gedde; Bettina S Husebo; Janne Mannseth; Mala Naik; Geir Selbaek; Maarja Vislapuu; Line Iden Berge Journal: BMC Med Date: 2022-05-26 Impact factor: 11.150