Geriatric Depression and Inappropriate Medication: Benefits of Interprofessional Team Cooperation in Nursing Homes

The (Mis)use of Psychotropic Drugs and Addiction to Anxiolytics among Older Adults Living at Home or in Retirement Homes: Implications for Quality of Life

Nowadays, the growing number of people aged 65+ has become a global phenomenon. At that age, the most common medical problems are multimorbidity and inappropriate polypharmacy, which have a negative impact on the quality of life in older adults. The aim of this cross-sectional study was to examine comorbidity, the use of psychopharmaceuticals, and symptoms of addiction to anxiolytics among older adults living at home or in retirement homes, and to examine the differences in quality of life in relation to the use and misuse of psychotropic drugs. The research included 383 people aged 65+ living in the Republic of Croatia (EU). A standardized questionnaire CAGE was used to collect data about the use of psychotropic drugs. Quality of life was examined using the WHOQOL-BREF scale. The average age of respondents was 83 years. There is a significantly higher prevalence of anxiety disorders (p = 0.001) in respondents who live at home. Psychopharmaceuticals were used by 218 (56.9%) respondents, equally in both groups of respondents. A total of 77 (20.1%) respondents had been using anxiolytics for more than five years, while 26 (6.8%) of them had significant clinical symptoms of addiction to anxiolytics. All domains and the overall quality of life scale were significantly lower (p < 0.001) in respondents who have clinical symptoms of anxiolytic addiction. The results indicate that the use of psychotropic drugs by respondents is inappropriate. Respondents who inappropriately and excessively use psychotropic drugs have a significantly worse quality of life.

The sociodemographic characteristics and clinical features of the late-life depression patients: results from the Beijing Anding Hospital mental health big data platform

BACKGROUND

The sociodemographic characteristics and clinical features of the Late-life depression (LLD) patients in psychiatric hospitals have not been thoroughly studied in China. This study aimed to explore the psychiatric outpatient attendance of LLD patients at a psychiatric hospital in China, with a subgroup analysis, such as with or without anxiety, gender differences.

METHODS

This retrospective study examined outpatients with LLD from January 2013 to August 2019 using data in the Observational Medical Outcomes Partnership Common Data Model (OMOP-CDM) in Beijing Anding Hospital. Age, sex, number of visits, use of drugs and comorbid conditions were extracted from medical records.

RESULTS

In a sample of 47,334 unipolar depression patients, 31,854 (67.30%) were women, and 15,480 (32.70%) were men. The main comorbidities of LDD are generalized anxiety disorder (GAD) (83.62%) and insomnia (74.52%).Among patients with unipolar depression, of which benzodiazepines accounted for the largest proportion (77.77%), Selective serotonin reuptake inhibitors (SSRIs) accounted for 59.00%, a noradrenergic and specific serotonergic antidepressant (NaSSAs) accounted for 36.20%. The average cost of each visit was approximately 646.27 yuan, and the cost of each visit was primarily attributed to Western medicine (22.97%) and Chinese herbal medicine (19.38%). For the cost of outpatient visits, depression comorbid anxiety group had a higher average cost than the non-anxiety group (p < 0.05). There are gender differences in outpatient costs, men spend more than women, for western medicine, men spend more than women, for Chinese herbal medicine, women spend more than men (all p < 0.05). The utilization rate of SSRIs and benzodiazepines in female patients is significantly higher than that in male patients (p < 0.05).

CONCLUSION

LLD patients are more commonly women than men and more commonly used SSRIs and NaSSAs. Elderly patients with depression often have comorbid generalized anxiety. LLD patients spend most of their visits on medicines, and while the examination costs are lower.