Potentially Inappropriate Use of Psychotropic Medications in Hospitalized Elderly Patients in France

Abstract

PIM use is common among hospitalized older adults in France. The most important determinant of risk of receiving a psychotropic medication or a PIP was the number of drugs being taken. The elderly, who have multiple co-morbidities, complex chronic conditions and are usually receiving polypharmacy, are at increased risk for adverse drug events. These adverse events are often linked to problems that could be preventable such as delirium, depression and falls. Regular review of prescriptions would help optimize prescription of psychotropics in the elderly. The Beers list is a good tool for evaluating PIMs but is too restrictive with respect to psychotropics; in the latter respect, the list could usefully be widened.

Potentially inappropriate prescription of antidepressants in old people: characteristics, associated factors, and impact on mortality

“…This is similar to the results of a cross-sectional study among 1306 inpatients aged ≥ 75 years in France (Prudent et al, 2008). Among the 263 inpatients treated by ADs, 29 (11%) received TCAs.…”

Application of STOPP/START and Beers criteria: Compared analysis on identification and relevance of potentially inappropriate prescriptions

“…Indeed, this study was conducted on a very small sample of clinical datasets (20 patients) and furthermore the extremely high prevalence of PIM measured lead some to suspect a selection bias in the sample selection. However, such as high prevalence of PIM was previously observed in other samples randomly selected from the same cohort and assessed with Beers 2003 and STOPP/START.v1 by clinicians and pharmacists from different European countries [25], and of acutely hospitalized old adults in one University hospital in Switzerland [41], in six different European hospitals [21], and in a multicentre SAFEs cohort study conducted in France [42]. This high prevalence has subsequently led to many changes according to PIM and PPO criteria.…”

An evaluation of the prevalence of potentially inappropriate medications in older people with cognitive impairment living in Northern Sweden using the EU(7)-PIM list

“…PIMs such as antipsychotics and other psychotropic drugs are commonly prescribed in order to treat symptoms due to dementia, even though these drugs are associated with severe ADRs [3, 8–10]. It is also seen that people with dementia on average take more medications compared to people without dementia [11].…”