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Older adults recently started on psychotropic medication: where are the symptoms?
Objective The objective of this study is to understand the characteristics of older adults on newly prescribed psychotropic medication with minimal psychiatric symptoms. Methods Naturalistic cohort study of non‐institutionalized older adults in Pennsylvania participating in the Pharmaceutical Assist...
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| Published in: | International journal of geriatric psychiatry 2015-06, Vol.30 (6), p.580-586 |
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| Main Authors: | , , , , , , , |
| Format: | Article |
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| cites | cdi_FETCH-LOGICAL-c5577-f3e301c8fc7b1f7f49738102ba3e0421e2cef969ea16f92bd5bfb01daf4f1a5f3 |
| container_end_page | 586 |
| container_issue | 6 |
| container_start_page | 580 |
| container_title | International journal of geriatric psychiatry |
| container_volume | 30 |
| creator | Maust, Donovan T. Chen, Shirley H. Benson, Amy Mavandadi, Shahrzad Streim, Joel E. DiFilippo, Suzanne Snedden, Thomas M. Oslin, David W. |
| description | Objective
The objective of this study is to understand the characteristics of older adults on newly prescribed psychotropic medication with minimal psychiatric symptoms.
Methods
Naturalistic cohort study of non‐institutionalized older adults in Pennsylvania participating in the Pharmaceutical Assistance Contract for the Elderly. Persons newly prescribed antidepressant or anxiolytic monotherapy or combination therapy were contacted for clinical assessment by a telephone‐based behavioral health service. The initial assessment included standardized mental health screening instruments and scales including the Blessed Orientation‐Memory‐Concentration test, Patient Health Questionnaire‐9, Generalized Anxiety Disorder‐7, and Medical Outcomes Survey (SF‐12). In addition, patients were asked for their understanding of the prescription indication.
Results
Of the 254 participants who met minimal symptom criteria (Patient Health Questionnaire‐9 |
| doi_str_mv | 10.1002/gps.4187 |
| format | article |
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The objective of this study is to understand the characteristics of older adults on newly prescribed psychotropic medication with minimal psychiatric symptoms.
Methods
Naturalistic cohort study of non‐institutionalized older adults in Pennsylvania participating in the Pharmaceutical Assistance Contract for the Elderly. Persons newly prescribed antidepressant or anxiolytic monotherapy or combination therapy were contacted for clinical assessment by a telephone‐based behavioral health service. The initial assessment included standardized mental health screening instruments and scales including the Blessed Orientation‐Memory‐Concentration test, Patient Health Questionnaire‐9, Generalized Anxiety Disorder‐7, and Medical Outcomes Survey (SF‐12). In addition, patients were asked for their understanding of the prescription indication.
Results
Of the 254 participants who met minimal symptom criteria (Patient Health Questionnaire‐9 < 5 and Generalized Anxiety Disorder‐7 < 5), women comprised slightly more of the anxiolytic compared with antidepressant monotherapy group (88.9% vs. 76.7%, p = 0.04). The most common self‐reported reason for prescription of an antidepressant or anxiolytic was depression or anxiety, respectively, despite near‐absence of these symptoms on clinical assessment. Comparing monotherapy to combination therapy groups, those with combination therapy were more likely to report a history of depression (12.6% vs. 1.8%, p < 0.001) and also report depression as the reason for the prescription (40.2% vs. 21.0%, p < 0.01).
Conclusions
In this sample of older adults on new psychotropic medication with minimal psychiatric symptoms, there are few patient characteristics that distinguish those on antidepressant versus anxiolytic monotherapy or those on monotherapy versus combination therapy. While quality of care in late‐life mental health has focused on improving detection and treatment, there should be further attention to low‐symptom patients potentially receiving inappropriate pharmacotherapy. Copyright © 2014 John Wiley & Sons, Ltd.</description><identifier>ISSN: 0885-6230</identifier><identifier>EISSN: 1099-1166</identifier><identifier>DOI: 10.1002/gps.4187</identifier><identifier>PMID: 25116369</identifier><identifier>CODEN: IJGPES</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Aged ; Aged, 80 and over ; Anti-Anxiety Agents - therapeutic use ; Antidepressive Agents - therapeutic use ; Anxiety Disorders - drug therapy ; Cohort Studies ; Community health care ; Depressive Disorder - drug therapy ; Drug therapy ; Female ; Geriatric psychiatry ; Geriatric psychology ; Health Knowledge, Attitudes, Practice ; Health Status ; Humans ; Male ; Mental Disorders - diagnosis ; Mental Disorders - drug therapy ; Mental health care ; Middle Aged ; older adults ; Older people ; Pennsylvania ; primary care ; Psychiatric Status Rating Scales ; Psychotropic drugs ; psychotropic medication</subject><ispartof>International journal of geriatric psychiatry, 2015-06, Vol.30 (6), p.580-586</ispartof><rights>Copyright © 2014 John Wiley & Sons, Ltd.</rights><rights>Copyright Wiley Subscription Services, Inc. Jun 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5577-f3e301c8fc7b1f7f49738102ba3e0421e2cef969ea16f92bd5bfb01daf4f1a5f3</citedby><cites>FETCH-LOGICAL-c5577-f3e301c8fc7b1f7f49738102ba3e0421e2cef969ea16f92bd5bfb01daf4f1a5f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25116369$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maust, Donovan T.</creatorcontrib><creatorcontrib>Chen, Shirley H.</creatorcontrib><creatorcontrib>Benson, Amy</creatorcontrib><creatorcontrib>Mavandadi, Shahrzad</creatorcontrib><creatorcontrib>Streim, Joel E.</creatorcontrib><creatorcontrib>DiFilippo, Suzanne</creatorcontrib><creatorcontrib>Snedden, Thomas M.</creatorcontrib><creatorcontrib>Oslin, David W.</creatorcontrib><title>Older adults recently started on psychotropic medication: where are the symptoms?</title><title>International journal of geriatric psychiatry</title><addtitle>Int J Geriatr Psychiatry</addtitle><description>Objective
The objective of this study is to understand the characteristics of older adults on newly prescribed psychotropic medication with minimal psychiatric symptoms.
Methods
Naturalistic cohort study of non‐institutionalized older adults in Pennsylvania participating in the Pharmaceutical Assistance Contract for the Elderly. Persons newly prescribed antidepressant or anxiolytic monotherapy or combination therapy were contacted for clinical assessment by a telephone‐based behavioral health service. The initial assessment included standardized mental health screening instruments and scales including the Blessed Orientation‐Memory‐Concentration test, Patient Health Questionnaire‐9, Generalized Anxiety Disorder‐7, and Medical Outcomes Survey (SF‐12). In addition, patients were asked for their understanding of the prescription indication.
Results
Of the 254 participants who met minimal symptom criteria (Patient Health Questionnaire‐9 < 5 and Generalized Anxiety Disorder‐7 < 5), women comprised slightly more of the anxiolytic compared with antidepressant monotherapy group (88.9% vs. 76.7%, p = 0.04). The most common self‐reported reason for prescription of an antidepressant or anxiolytic was depression or anxiety, respectively, despite near‐absence of these symptoms on clinical assessment. Comparing monotherapy to combination therapy groups, those with combination therapy were more likely to report a history of depression (12.6% vs. 1.8%, p < 0.001) and also report depression as the reason for the prescription (40.2% vs. 21.0%, p < 0.01).
Conclusions
In this sample of older adults on new psychotropic medication with minimal psychiatric symptoms, there are few patient characteristics that distinguish those on antidepressant versus anxiolytic monotherapy or those on monotherapy versus combination therapy. While quality of care in late‐life mental health has focused on improving detection and treatment, there should be further attention to low‐symptom patients potentially receiving inappropriate pharmacotherapy. Copyright © 2014 John Wiley & Sons, Ltd.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Anxiety Agents - therapeutic use</subject><subject>Antidepressive Agents - therapeutic use</subject><subject>Anxiety Disorders - drug therapy</subject><subject>Cohort Studies</subject><subject>Community health care</subject><subject>Depressive Disorder - drug therapy</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Geriatric psychiatry</subject><subject>Geriatric psychology</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Health Status</subject><subject>Humans</subject><subject>Male</subject><subject>Mental Disorders - diagnosis</subject><subject>Mental Disorders - drug therapy</subject><subject>Mental health care</subject><subject>Middle Aged</subject><subject>older adults</subject><subject>Older people</subject><subject>Pennsylvania</subject><subject>primary care</subject><subject>Psychiatric Status Rating Scales</subject><subject>Psychotropic drugs</subject><subject>psychotropic medication</subject><issn>0885-6230</issn><issn>1099-1166</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNqN0V2L1DAUBuAgijuugr9AAt540zUn6Ufqjeiiozi4fg94E9L0xOlu29QkZe2_N8OOKwjCXoRzkYcXznkJeQjsBBjjT39M4SQHWd0iK2B1nQGU5W2yYlIWWckFOyL3QjhnLP2BvEuOeJGEKOsV-XjWt-ipbuc-BurR4Bj7hYaofcSWupFOYTE7F72bOkMHbDujY-fGZ_Ryhx6pTi_ukIZlmKIbwvP75I7VfcAHh3lMvr5-9eX0TbY5W789fbHJTFFUVWYFCgZGWlM1YCub15WQwHijBbKcA3KDti5r1FDamjdt0diGQattbkEXVhyTJ1e5k3c_ZwxRDV0w2Pd6RDcHBWVdgJRp5RtQKUTB8vxGlIHkkvFEH_9Dz93sx7TzXvGa5ZWEv4HGuxA8WjX5btB-UcDUvjyVylP78hJ9dAicm3Toa_inrQSyK3DZ9bj8N0itP3w-BB58FyL-uvbaX6iyElWhtu_X6tN2_e3l9807tRW_AZvZscY</recordid><startdate>201506</startdate><enddate>201506</enddate><creator>Maust, Donovan T.</creator><creator>Chen, Shirley H.</creator><creator>Benson, Amy</creator><creator>Mavandadi, Shahrzad</creator><creator>Streim, Joel E.</creator><creator>DiFilippo, Suzanne</creator><creator>Snedden, Thomas M.</creator><creator>Oslin, David W.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope></search><sort><creationdate>201506</creationdate><title>Older adults recently started on psychotropic medication: where are the symptoms?</title><author>Maust, Donovan T. ; Chen, Shirley H. ; Benson, Amy ; Mavandadi, Shahrzad ; Streim, Joel E. ; DiFilippo, Suzanne ; Snedden, Thomas M. ; Oslin, David W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5577-f3e301c8fc7b1f7f49738102ba3e0421e2cef969ea16f92bd5bfb01daf4f1a5f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anti-Anxiety Agents - therapeutic use</topic><topic>Antidepressive Agents - therapeutic use</topic><topic>Anxiety Disorders - drug therapy</topic><topic>Cohort Studies</topic><topic>Community health care</topic><topic>Depressive Disorder - drug therapy</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Geriatric psychiatry</topic><topic>Geriatric psychology</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Health Status</topic><topic>Humans</topic><topic>Male</topic><topic>Mental Disorders - diagnosis</topic><topic>Mental Disorders - drug therapy</topic><topic>Mental health care</topic><topic>Middle Aged</topic><topic>older adults</topic><topic>Older people</topic><topic>Pennsylvania</topic><topic>primary care</topic><topic>Psychiatric Status Rating Scales</topic><topic>Psychotropic drugs</topic><topic>psychotropic medication</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maust, Donovan T.</creatorcontrib><creatorcontrib>Chen, Shirley H.</creatorcontrib><creatorcontrib>Benson, Amy</creatorcontrib><creatorcontrib>Mavandadi, Shahrzad</creatorcontrib><creatorcontrib>Streim, Joel E.</creatorcontrib><creatorcontrib>DiFilippo, Suzanne</creatorcontrib><creatorcontrib>Snedden, Thomas M.</creatorcontrib><creatorcontrib>Oslin, David W.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><jtitle>International journal of geriatric psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maust, Donovan T.</au><au>Chen, Shirley H.</au><au>Benson, Amy</au><au>Mavandadi, Shahrzad</au><au>Streim, Joel E.</au><au>DiFilippo, Suzanne</au><au>Snedden, Thomas M.</au><au>Oslin, David W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Older adults recently started on psychotropic medication: where are the symptoms?</atitle><jtitle>International journal of geriatric psychiatry</jtitle><addtitle>Int J Geriatr Psychiatry</addtitle><date>2015-06</date><risdate>2015</risdate><volume>30</volume><issue>6</issue><spage>580</spage><epage>586</epage><pages>580-586</pages><issn>0885-6230</issn><eissn>1099-1166</eissn><coden>IJGPES</coden><abstract>Objective
The objective of this study is to understand the characteristics of older adults on newly prescribed psychotropic medication with minimal psychiatric symptoms.
Methods
Naturalistic cohort study of non‐institutionalized older adults in Pennsylvania participating in the Pharmaceutical Assistance Contract for the Elderly. Persons newly prescribed antidepressant or anxiolytic monotherapy or combination therapy were contacted for clinical assessment by a telephone‐based behavioral health service. The initial assessment included standardized mental health screening instruments and scales including the Blessed Orientation‐Memory‐Concentration test, Patient Health Questionnaire‐9, Generalized Anxiety Disorder‐7, and Medical Outcomes Survey (SF‐12). In addition, patients were asked for their understanding of the prescription indication.
Results
Of the 254 participants who met minimal symptom criteria (Patient Health Questionnaire‐9 < 5 and Generalized Anxiety Disorder‐7 < 5), women comprised slightly more of the anxiolytic compared with antidepressant monotherapy group (88.9% vs. 76.7%, p = 0.04). The most common self‐reported reason for prescription of an antidepressant or anxiolytic was depression or anxiety, respectively, despite near‐absence of these symptoms on clinical assessment. Comparing monotherapy to combination therapy groups, those with combination therapy were more likely to report a history of depression (12.6% vs. 1.8%, p < 0.001) and also report depression as the reason for the prescription (40.2% vs. 21.0%, p < 0.01).
Conclusions
In this sample of older adults on new psychotropic medication with minimal psychiatric symptoms, there are few patient characteristics that distinguish those on antidepressant versus anxiolytic monotherapy or those on monotherapy versus combination therapy. While quality of care in late‐life mental health has focused on improving detection and treatment, there should be further attention to low‐symptom patients potentially receiving inappropriate pharmacotherapy. Copyright © 2014 John Wiley & Sons, Ltd.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>25116369</pmid><doi>10.1002/gps.4187</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | International journal of geriatric psychiatry, 2015-06, Vol.30 (6), p.580-586 |
| issn | 0885-6230 1099-1166 |
| language | eng |
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| subjects | Aged Aged, 80 and over Anti-Anxiety Agents - therapeutic use Antidepressive Agents - therapeutic use Anxiety Disorders - drug therapy Cohort Studies Community health care Depressive Disorder - drug therapy Drug therapy Female Geriatric psychiatry Geriatric psychology Health Knowledge, Attitudes, Practice Health Status Humans Male Mental Disorders - diagnosis Mental Disorders - drug therapy Mental health care Middle Aged older adults Older people Pennsylvania primary care Psychiatric Status Rating Scales Psychotropic drugs psychotropic medication |
| title | Older adults recently started on psychotropic medication: where are the symptoms? |
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