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| [PMID]: | 28448697 |
| [Au] Autor: | Maust DT; Blow FC; Wiechers IR; Kales HC; Marcus SC |
| [Ad] Endereço: | Department of Psychiatry, University of Michigan, NCRC 016-222W, 2800 Plymouth Rd, Ann Arbor, MI 48109. maustd@umich.edu. |
| [Ti] Título: | National Trends in Antidepressant, Benzodiazepine, and Other Sedative-Hypnotic Treatment of Older Adults in Psychiatric and Primary Care. |
| [So] Source: | J Clin Psychiatry;78(4):e363-e371, 2017 Apr. | | [Is] ISSN: | 1555-2101 |
| [Cp] País de publicação: | United States |
| [La] Idioma: | eng |
| [Ab] Resumo: | OBJECTIVE: To describe how use of antidepressants, benzodiazepines, and other anxiolytic/sedative-hypnotics among older adults (age ≥ 65 years) has changed over time among visits to primary care providers and psychiatrists. METHODS: Data were from the National Ambulatory Medical Care Survey (years 2003-2005 and 2010-2012), a nationally representative cross-section of outpatient physician visits. Analysis focused on visits to primary care providers (n = 14,282) and psychiatrists (n = 1,095) at which an antidepressant, benzodiazepine, or other anxiolytic/sedative-hypnotic was prescribed, which were stratified by demographic and clinical characteristic (including ICD-9-CM diagnosis) and compared across study intervals. Odds of medication use were calculated for each stratum, adjusting for demographic and clinical characteristics. RESULTS: The visit rate by older adults to primary care providers where any of the medications were prescribed rose from 16.4% to 21.8% (adjusted odds ratio [AOR] = 1.43, P < .001) while remaining steady among psychiatrists (75.4% vs 68.5%; AOR = 0.69, P = .11). Primary care visits rose for antidepressants (9.9% to 12.3%; AOR = 1.28, P = .01) and other anxiolytic/sedative-hypnotics (3.4% to 4.7%; AOR = 1.39, P = .01), but the largest growth was among benzodiazepines (5.6% to 8.7%; AOR = 1.62, P < .001). Among patients in primary care, increases primarily occurred among men, non-Hispanic white patients, and those with pain diagnoses as well as those with no mental health or pain diagnoses. CONCLUSIONS: From 2003 to 2012, use of the most common psychotropic medications among older adults seen in primary care increased, with concentration among patients with no mental health or pain diagnosis. As the population of older adults grows and receives mental health treatment in primary care, it is critical to examine the appropriateness of psychotropic use. |
| [Mh] Termos MeSH primário: |
Antidepressivos/uso terapêutico
Benzodiazepinas/uso terapêutico
Hipnóticos e Sedativos/uso terapêutico
Médicos de Atenção Primária/estatística & dados numéricos
Atenção Primária à Saúde/estatística & dados numéricos
Psiquiatria/estatística & dados numéricos
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| [Mh] Termos MeSH secundário: |
Idoso
Idoso de 80 Anos ou mais
Estudos Transversais
Feminino
Pesquisas sobre Serviços de Saúde
Seres Humanos
Masculino
Médicos de Atenção Primária/tendências
Atenção Primária à Saúde/tendências
Psiquiatria/tendências
Estados Unidos
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| [Pt] Tipo de publicação: | JOURNAL ARTICLE |
[Nm] Nome de substância:
| 0 (Antidepressive Agents); 0 (Hypnotics and Sedatives); 12794-10-4 (Benzodiazepines) |
| [Em] Mês de entrada: | 1706 |
| [Cu] Atualização por classe: | 180308 |
[Lr] Data última revisão:
| 180308 |
| [Sb] Subgrupo de revista: | IM |
| [Da] Data de entrada para processamento: | 170428 |
| [St] Status: | MEDLINE |
| [do] DOI: | 10.4088/JCP.16m10713 |
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