Psychotropic drug use among older people in general practice: discrepancies between opinion and practice.
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.
Lasserre
Andrea
A
INSERM, U707, Paris, France; UPMC Université Paris 6, UMR S707, Paris, France. lasserre@u707.jussieu.fr
Younès
Nadia
N
Blanchon
Thierry
T
Cantegreil-Kallen
Inge
I
Passerieux
Christine
C
Thomas
Guy
G
Chan-Chee
Christine
C
Hanslik
Thomas
T
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*
D011619:Psychotropic Drugs