title: Telephone-based behavioral health assessment for older adults starting a new psychiatric medication.
abstract: OBJECTIVE
  The purpose of this study is to explore behavioral health symptoms and characteristics of noninstitutionalized older adults newly started on an antidepressant, anxiolytic, or antipsychotic agent by nonpsychiatrist physicians.
  
  
  METHODS
  Naturalistic cohort study of older adults participating in the Pharmaceutical Assistance Contract for the Elderly (PACE) of the state of Pennsylvania.
  
  
  METHODS
  Noninstitutionalized adults in Pennsylvania.
  
  
  METHODS
  Standardized scales including the Blessed Orientation-Memory-Concentration (BOMC) test, Mini International Neuropsychiatric Interview (including Psychosis, Mania, Generalized Anxiety Disorder [GAD], Panic Disorder, and Alcohol Abuse/Dependence modules), Patient Health Questionnaire-9 (PHQ-9), Paykel Scale for suicide ideation, and Medical Outcomes Survey (SF-12).
  
  
  RESULTS
  Participants were mostly women (83.7%) with a mean age of 79.2 years (SD 7.1). The average PHQ-9 score for those on antidepressants was 5.8 (5.2), with no statistically significant difference between medication groups (F[2, 409] = 1.48, p = 0.23); just seven (4.9%) of those receiving anxiolytics met criteria for an anxiety disorder, which was not significantly different than other medication classes (χ (2) = 0.83, p = 0.66). Overall, 197 (47.8%) of the sample did not meet criteria for a mental health disorder. Just 69 (28.8%) of those on antidepressants reported depression as the self-reported reason for taking the medication, while 91 (22.8%) of the total reported poor sleep or stressful life events as the reason.
  
  
  CONCLUSIONS
  In this sample, many older persons received psychotropic medications despite low symptomatology, increasing the costs of care and possible exposure to unnecessary side effects. It is important to understand perceived benefit to both patient and provider of such prescribing patterns and work towards minimizing unnecessary use.
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia Veterans Affairs Medical Center, USA. Donovan.Maust@uphs.upenn.edu
authors.forename: Donovan T
authors.initials: DT
authors.lastname: Maust
authors.forename: Shahrzad
authors.initials: S
authors.lastname: Mavandadi
authors.forename: April
authors.initials: A
authors.lastname: Eakin
authors.forename: Joel E
authors.initials: JE
authors.lastname: Streim
authors.forename: Suzanne
authors.initials: S
authors.lastname: Difillipo
authors.forename: Thomas
authors.initials: T
authors.lastname: Snedden
authors.forename: David W
authors.initials: DW
authors.lastname: Oslin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data*; D006306:Health Surveys / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000188:drug therapy*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D057566:Self Report; D013689:Telephone
chemical_list: D011619:Psychotropic Drugs