Potentially inappropriate psychotropic prescription at discharge is ă associated with lower functioning in the elderly psychiatric inpatients. ă A cross-sectional study

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Objective The objectives are to determine the rate of potentially ă inappropriate psychotropic (PIP) prescription at discharge in the ă elderly psychiatric inpatients and to determine whether PIP is ă associated with lowered functioning outcomes. ă Methods Sociodemographic, clinical, and treatment data for all ă inpatients aged >= 65 years consecutively hospitalized during 1 year in ă 13 psychiatry departments was analyzed. PIP+/PIP- groups were defined ă according to the French-updated Beers criteria. Daily functioning was ă evaluated by the daily living (ADL) scale. Logistic regression analysis ă was used to estimate odds ratios for the association between PIP ă administration at discharge and respectively functioning and potential ă confounding factors. ă Results Data was obtained for 327 patients. Overall, 124 (37.9 %) ă patients were males, and the mean age was 73.9 years (SD=5.6); 163 ă (49.8%) patients were diagnosed with affective disorders and 89 ă (27.2%) with schizophrenia/schizotypal/delusional disorders. Overall, ă 249 (76.1 %) had one or more PIP medications, mainly anxiolytics (69.9 ă %) and hypnotics (17.2 %). In a multivariate analysis, PIP ă prescription at discharge has been associated with patient lowered ă personal care functioning, independently of age, gender, and psychiatric ă or somatic diagnoses (OR=0.88 (0.79-0.97, p=0.01). ă Conclusion In the current increasingly fragmented health care systems, ă special attention must be given to PIP prescription in older population ă suffering from psychiatric disorders. Using the Beers criteria, the ă present study demonstrates the high prevalence of PIP prescription, ă which concerns a large panel of drugs but mostly anxiolytics and ă hypnotics independently of psychiatric or somatic diagnoses and ă sociodemographic characteristics. Our study has demonstrated for the ă first time an association between PIP prescription and lowered patient ă functioning. Further longitudinal studies should confirm a potential ă causal relation.

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