title: Psychotropic drug use among older people in general practice: discrepancies between opinion and practice.
abstract: BACKGROUND
  The use of psychotropic drugs has increased over recent years in France. GPs are the first prescribers, especially for older patients.
  
  
  OBJECTIVE
  To analyse discrepancies between GPs' opinions and practice when prescribing psychotropic drugs to older patients.
  
  
  METHODS
  Postal surveys sent to GPs all over mainland France.
  
  
  METHODS
  Cross-sectional postal study.
  
  
  METHODS
  A questionnaire collected data on characteristics of GPs' practices, their opinions about psychotropic drug consumption in older people, and a full description of their last older patient receiving a psychotropic drug and seen last by the GP on that particular day.
  
  
  RESULTS
  A total of 350 participating GPs saw 2498 patients aged > or =65 years. Among these patients, the prevalence of psychotropic use was 32.1% (803/2498) for anxiolytics/hypnotics, and 17.5% for antidepressants (438/2498). A total of 91% of GPs agreed that it was possible to reduce or stop psychotropic drugs for these patients. Characteristics of 339 patients taking psychotropic drug were reported: 85.8% (291/339) received at least one anxiolytic/hypnotic and 56.9% (193/339) received at least one antidepressant; there were prescribed for more than 1 year in 68.4% (199/291) and 43.5% (84/193) of the cases respectively. GPs stated that it was possible to reduce or stop anxiolytic/hypnotic drugs for only 27% (79/291) of these patients. Barriers to doing this were patients' refusal (79%), and the absence of any local offer of psychotherapy (73%) or alternative therapy (70%).
  
  
  CONCLUSIONS
  A mismatch exists between GPs' intent (91%) and practice (27%) regarding reduction of psychotropic prescription in individuals aged > or =65 years. The barriers encountered should be examined further to help physicians improve management of psychotropic prescription.
authors.affiliation: INSERM, U707, Paris, France; UPMC Université Paris 6, UMR S707, Paris, France. lasserre@u707.jussieu.fr
authors.forename: Andrea
authors.initials: A
authors.lastname: Lasserre
authors.forename: Nadia
authors.initials: N
authors.lastname: Younès
authors.forename: Thierry
authors.initials: T
authors.lastname: Blanchon
authors.forename: Inge
authors.initials: I
authors.lastname: Cantegreil-Kallen
authors.forename: Christine
authors.initials: C
authors.lastname: Passerieux
authors.forename: Guy
authors.initials: G
authors.lastname: Thomas
authors.forename: Christine
authors.initials: C
authors.lastname: Chan-Chee
authors.forename: Thomas
authors.initials: T
authors.lastname: Hanslik
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D005602:France; D058006:General Practice / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011619:Psychotropic Drugs / Q000627:therapeutic use*
chemical_list: D011619:Psychotropic Drugs