Namkee G Choi1, C Nathan Marti1, Mark E Kunik1. 1. Steve Hicks School of Social Work, University of Texas at Austin, Austin (Choi, Marti); Behavioral Health and Implementation Program, U.S. Department of Veterans Affairs South Central Mental Illness Research, Education, and Clinical Center, Houston (Kunik); Department of Psychiatry, Baylor College of Medicine, Houston (Kunik).
Abstract
OBJECTIVE: The authors assessed central nervous system (CNS) polypharmacy among low-income, racially diverse homebound older adults with depression (N=277) and its associations with the participants' ratings of depressive symptoms and pain. METHODS: CNS-active and other psychotropic and analgesic medications intake was collected from patients' medication containers. Depressive symptoms were assessed with the 24-item Hamilton Depression Rating Scale, and pain intensity was measured on an 11-point numerical rating scale. Covariates were disability (World Health Organization Disability Assessment Schedule 2.0) and perceived social support (Multidimensional Scale of Perceived Social Support). RESULTS: Of the patients, 16% engaged in CNS polypharmacy, taking three or more CNS-active medications. Of these, 69%, 69%, and 89% were using selective serotonin reuptake inhibitors, benzodiazepines, and opioids, respectively. Higher pain intensity ratings were associated with CNS polypharmacy. Benzodiazepine users were more likely than nonusers to use opioids. CONCLUSIONS: Medication reviews and improved access to evidence-based psychotherapeutic treatments are needed for these older individuals with depression.
OBJECTIVE: The authors assessed central nervous system (CNS) polypharmacy among low-income, racially diverse homebound older adults with depression (N=277) and its associations with the participants' ratings of depressive symptoms and pain. METHODS: CNS-active and other psychotropic and analgesic medications intake was collected from patients' medication containers. Depressive symptoms were assessed with the 24-item Hamilton Depression Rating Scale, and pain intensity was measured on an 11-point numerical rating scale. Covariates were disability (World Health Organization Disability Assessment Schedule 2.0) and perceived social support (Multidimensional Scale of Perceived Social Support). RESULTS: Of the patients, 16% engaged in CNS polypharmacy, taking three or more CNS-active medications. Of these, 69%, 69%, and 89% were using selective serotonin reuptake inhibitors, benzodiazepines, and opioids, respectively. Higher pain intensity ratings were associated with CNS polypharmacy. Benzodiazepine users were more likely than nonusers to use opioids. CONCLUSIONS: Medication reviews and improved access to evidence-based psychotherapeutic treatments are needed for these older individuals with depression.
Authors: M Gutiérrez-Valencia; M Izquierdo; M Cesari; Á Casas-Herrero; M Inzitari; N Martínez-Velilla Journal: Br J Clin Pharmacol Date: 2018-05-03 Impact factor: 4.335
Authors: Katherine A Ornstein; Bruce Leff; Kenneth E Covinsky; Christine S Ritchie; Alex D Federman; Laken Roberts; Amy S Kelley; Albert L Siu; Sarah L Szanton Journal: JAMA Intern Med Date: 2015-07 Impact factor: 21.873
Authors: Macarena C García; Charles M Heilig; Scott H Lee; Mark Faul; Gery Guy; Michael F Iademarco; Katherine Hempstead; Dorrie Raymond; Josh Gray Journal: MMWR Morb Mortal Wkly Rep Date: 2019-01-18 Impact factor: 17.586
Authors: Collin J Amundson; Robert Knight; Georgina M Ybarra; Jacques Turgeon; Jennifer M Bingham Journal: Medicina (Kaunas) Date: 2022-03-17 Impact factor: 2.430