title: Factors influencing prescription of CNS medications in different elderly populations.
abstract: Factors influencing the use of neuroleptic and other CNS-acting medications ('antidepressants' and 'hypnotics/anxiolytics') were examined in different elderly populations (> 65 years): long-stay care hospital subjects (n = 381), nursing home subjects (n = 1247), private residential home subjects (n = 321), statutory residential home subjects (n = 525), old age psychiatry facility subjects (n = 48), community dwellers (n = 97), in different geographical areas (urban n = 1223 and rural n = 1396). Neuroleptics were prescribed in 28% of the individuals, hypnotics/anxiolytics in 33% and antidepressants in 12%. Prescription of neuroleptics was significantly predicted by institutional placement (other than long-stay care hospital facility), lower cognitive function and rural geographical area. Age greater than 75 years and lower functional score (lower dependency) significantly decreased the likelihood of receipt of neuroleptics. Antidepressant use was significantly less likely in male subjects, patients with cognitive impairment and patients greater than 85 years. Institutional placement (other than long-stay care hospital facility and old age psychiatry facility) and rural locality predicted increased likelihood of antidepressant prescription. Institutional placement (other than long-stay care hospital facility) and geographical (rural) location were significant independent predictors of hypnotic/anxiolytic use. Prescription of hypnotic/anxiolytic drug class was significantly less likely in those individuals with lower cognitive status. In this representative elderly cohort, patient characteristics: age, sex, cognitive score, functional score, place of residence and geographical location markedly influenced drug utilisation.
authors.affiliation: Department of Geriatric Medicine, Queen's University of Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK. david.craig@qub.ac.uk
authors.forename: David
authors.initials: D
authors.lastname: Craig
authors.forename: A Peter
authors.initials: AP
authors.lastname: Passmore
authors.forename: Ken J
authors.initials: KJ
authors.lastname: Fullerton
authors.forename: Timothy R O
authors.initials: TR
authors.lastname: Beringer
authors.forename: David H
authors.initials: DH
authors.lastname: Gilmore
authors.forename: Vivienne L S
authors.initials: VL
authors.lastname: Crawford
authors.forename: Patricia M
authors.initials: PM
authors.lastname: McCaffrey
authors.forename: Anne
authors.initials: A
authors.lastname: Montgomery
mesh_terms: D000368:Aged / Q000502:physiology*; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002490:Central Nervous System / Q000187:drug effects*; D002491:Central Nervous System Agents / Q000494:pharmacology*; D003625:Data Collection / Q000706:statistics & numerical data*; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007297:Inpatients; D008297:Male; D010045:Outpatients; D017891:Pharmacoepidemiology
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D002491:Central Nervous System Agents; D006993:Hypnotics and Sedatives