title: The effects of medication assessment on psychotropic drug use in the community-dwelling elderly.
abstract: BACKGROUND
  The study evaluated the effects of an annual medication assessment conducted as part of a Comprehensive Geriatric Assessment (CGA) on the prevalence of psychotropic drug use in community-dwelling elderly people.
  
  
  METHODS
  Randomly selected persons (n = 1000) aged ≥75 years living in the city of Kuopio, Finland were randomized to intervention and control groups. The intervention group underwent an annual (2004-2006) medication assessment as part of a CGA by physicians. Data on drug use were gathered by interviews at baseline (2004) and in three following years (2005-2007). Generalized estimating equations (GEE) were applied to explore whether the prevalence of psychotropic drug use differed between the community-dwelling participants of the intervention (n = 361) and control groups (n = 339) over time.
  
  
  RESULTS
  At baseline, nearly 40% of the participants used psychotropic drugs in each group. In the intervention group, the study physicians implemented 126 psychotropic drug-related changes, 39% of which were persistent after one year. The prevalence of use of psychotropic drugs, antipsychotics and anxiolytic/hypnotics did not differ between the groups over time. The prevalence of antidepressant use remained constant in the intervention group, but increased in the control group (p-value for interaction = 0.039). The prevalence of concomitant use of psychotropic drugs decreased non-significantly in the intervention group, but increased in the control group (p-value for interaction = 0.009).
  
  
  CONCLUSIONS
  Conducting an annual medication assessment outside the usual primary health care system does not appear to reduce the prevalence of psychotropic drug use in community-dwelling elderly people. However, it may prevent concomitant use of psychotropic drugs.
authors.affiliation: Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland. maria.rikala@uef.fi
authors.forename: Maria
authors.initials: M
authors.lastname: Rikala
authors.forename: Maarit Jaana
authors.initials: MJ
authors.lastname: Korhonen
authors.forename: Raimo
authors.initials: R
authors.lastname: Sulkava
authors.forename: Sirpa
authors.initials: S
authors.lastname: Hartikainen
mesh_terms: D000368:Aged / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D005260:Female; D005387:Finland; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data; D007407:Interviews as Topic; D008297:Male; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use*; D011795:Surveys and Questionnaires
chemical_list: D011619:Psychotropic Drugs