Racial-Ethnic Variations in Potentially Inappropriate Psychotropic Medication Use Among the Elderly

Abstract

Objective: Psychotropic drugs are among the most frequently prescribed medications to the elderly in the USA. Yet, many of those drugs have been used inappropriately. Increased risks of potentially inappropriate psychotropic medication (PIPM) utilization are associated with several patient and provider characteristics. However, little is known whether and to what extent patient race and ethnicity is related to PIPM use patterns among the elderly.

Methods: We used multiyear (2012-2015) Medical Expenditure Panel Survey (MEPS) data. Among elderly psychotropic drug users (N = 7616), we identified PIPM prescription fills based on a Beers criterion, a list of drugs (by generic names) that should be avoided at any circumstances among the elderly. Logistic regression was used for the likelihood analysis.

Results: The likelihood of filling PIPMs was higher among Hispanics than among Whites (adjusted odds ratio [AOR] = 1.22; 95% confidence interval [CI] = 1.02-1.46). No differences were found between Whites and Blacks. The prevalence of PIPM use is high in all racial groups (43-52%).

Conclusion: We found differences in the use of PIPMs by patient race and ethnicity between 2012 and 2015: among elderly psychotropic medication users, Hispanics were more likely than Whites to receive PIPMs. More clinical and policy efforts should aim to reduce PIPM use in all groups, particularly among Hispanic, given potentially negative health consequences related with the use of inappropriate medications.

Keywords: Beers criteria; Elderly; Inappropriate medication use; Psychotropic drugs; Racial-ethnic difference.