The effects of medication assessment on psychotropic drug use in the community-dwelling elderly.
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.
Rikala
Maria
M
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland. maria.rikala@uef.fi
Korhonen
Maarit Jaana
MJ
Sulkava
Raimo
R
Hartikainen
Sirpa
S
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
D011619:Psychotropic Drugs