Compliance of psychotropic drug prescription with clinical practice guidelines in older inpatients.

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Clinical Guidelines
Authored By
Etchepare F, Pambrun E, Bégaud B, Verdoux H, Tournier M
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Psychiatry
Speciality
Psychiatry
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volume
30
ISSN
1472-8206
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ISSN
1472-8206
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true
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Additional Info
["Etchepare F, Pambrun E, B\u00e9gaud B, Verdoux H, Tournier M","Publisher: Blackwell Science Country of Publication: England NLM ID: 8710411 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1472-8206 (Electronic) Linking ISSN: 07673981 NLM ISO Abbreviation: Fundam Clin Pharmacol Subsets: MEDLINE","Journal Article; Research Support, Non-U.S. Gov't","2016-02-01","Fundamental & clinical pharmacology [Fundam Clin Pharmacol] 2016 Feb; Vol. 30 (1), pp. 82-92. Date of Electronic Publication: 2015 Dec 16.","English","1472-8206","Medication Adherence* , Practice Guidelines as Topic*, Clinical Medicine\/*standards , Drug Prescriptions\/*statistics & numerical data , Psychotropic Drugs\/*therapeutic use, Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Electronic Health Records ; Female ; France ; Hospitalization\/statistics & numerical data ; Humans ; Logistic Models ; Male ; Multivariate Analysis ; Psychiatric Department, Hospital\/statistics & numerical data ; Psychotropic Drugs\/administration & dosage ; Psychotropic Drugs\/pharmacokinetics ; Random Allocation ; Socioeconomic Factors","Aged, Aged, 80 and over, Cross-Sectional Studies, Electronic Health Records, Female, France, Hospitalization statistics & numerical data, Humans, Logistic Models, Male, Multivariate Analysis, Psychiatric Department, Hospital statistics & numerical data, Psychotropic Drugs administration & dosage, Psychotropic Drugs pharmacokinetics, Random Allocation, Socioeconomic Factors, Clinical Medicine standards, Drug Prescriptions statistics & numerical data, Medication Adherence, Practice Guidelines as Topic, Psychotropic Drugs therapeutic use","Fundamental & clinical pharmacology","30"]
Description
Several practice guidelines were published by French regulatory agencies between 2006 and 2009 to improve psychotropic drug use in older patients. The objectives of the study were to assess compliance with these guidelines in older patients hospitalized in psychiatric units and to identify characteristics associated with compliance. A cross-sectional study was conducted in 117 patients aged 65 years and older hospitalized in two psychiatric departments of a public hospital, at three dates randomly chosen between January and May 2014. Medical and sociodemographic characteristics were collected from electronic medical records. In all, 8% of psychotropic prescriptions were compliant with guidelines. A total of 98% of antidepressant prescriptions complied with guidelines for product selection (no tricyclics) and 72% for initial dosage (half of that recommended for younger adults). Regarding benzodiazepines, short half-life drugs were chosen in 73% of treatments, low maintenance dosage was found in 64% of treatments, and a discontinuous administration rhythm was noted in 33% of treatments. Regarding antipsychotics, initial dosage was a quarter of the allowed initial dosage for younger adults in 39% of prescriptions and metabolic blood testing was performed in 17% of prescriptions. Neurological and cognitive tolerance was monitored in 41% and 61% of prescriptions, respectively. Few clinical factors were found to be associated with compliance or noncompliance with guidelines in older psychiatric inpatients. Practice guidelines on psychotropic drug prescription were partially respected in older inpatients. Practitioners should take into account the risks associated with non-recommended patterns of psychotropic drug use in this vulnerable population.<br /> (© 2015 Société Française de Pharmacologie et de Thérapeutique.)
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