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Multicenter Study
. 2010 Apr;60(573):e156-62.
doi: 10.3399/bjgp10X483922.

Psychotropic drug use among older people in general practice: discrepancies between opinion and practice

Andrea Lasserre  1 , Nadia Younès, Thierry Blanchon, Inge Cantegreil-Kallen, Christine Passerieux, Guy Thomas, Christine Chan-Chee, Thomas Hanslik
Affiliations
Multicenter Study

Psychotropic drug use among older people in general practice: discrepancies between opinion and practice

Andrea Lasserre et al. Br J Gen Pract. 2010 Apr.

Abstract

Background: The use of psychotropic drugs has increased over recent years in France. GPs are the first prescribers, especially for older patients.

Aim: To analyse discrepancies between GPs' opinions and practice when prescribing psychotropic drugs to older patients.

Setting: Postal surveys sent to GPs all over mainland France.

Design of study: Cross-sectional postal study.

Method: A questionnaire collected data on characteristics of GPs' practices, their opinions about psychotropic drug consumption in older people, and a full description of their last older patient receiving a psychotropic drug and seen last by the GP on that particular day.

Results: A total of 350 participating GPs saw 2498 patients aged > or =65 years. Among these patients, the prevalence of psychotropic use was 32.1% (803/2498) for anxiolytics/hypnotics, and 17.5% for antidepressants (438/2498). A total of 91% of GPs agreed that it was possible to reduce or stop psychotropic drugs for these patients. Characteristics of 339 patients taking psychotropic drug were reported: 85.8% (291/339) received at least one anxiolytic/hypnotic and 56.9% (193/339) received at least one antidepressant; there were prescribed for more than 1 year in 68.4% (199/291) and 43.5% (84/193) of the cases respectively. GPs stated that it was possible to reduce or stop anxiolytic/hypnotic drugs for only 27% (79/291) of these patients. Barriers to doing this were patients' refusal (79%), and the absence of any local offer of psychotherapy (73%) or alternative therapy (70%).

Conclusion: A mismatch exists between GPs' intent (91%) and practice (27%) regarding reduction of psychotropic prescription in individuals aged > or =65 years. The barriers encountered should be examined further to help physicians improve management of psychotropic prescription.

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Figures

Figure 1
Figure 1
GPs' general opinions on ways to reduce anxiolytic/hypnotic prescriptions among patients aged ≥65 years.
Figure 2
Figure 2
Barriers to reduce or stop anxiolytic or hypnotic drugs in patients aged ≥65 years.
See this image and copyright information in PMC

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