title: Psychoactive prescribing for older people--what difference does 15 years make?
abstract: OBJECTIVE
  The objective of the study was to review prescribing of psychoactive medications for older residents of the Tayside region of Scotland.
  
  
  METHODS
  The analysis used community prescribing data in 1995 and 2010 for all older residents in Tayside. For each psychoactive drug class, the name of the most recently prescribed drug and the date prescribed were extracted. The relative risk (RR) and 95% confidence intervals (CI) for patients receiving psychoactive medication in 2010 were compared with those for patients in 1995. Psychoactive prescribing was analyzed by year, age, gender, and deprivation classification. The chi-squared test was used to calculate statistical significance.
  
  
  RESULTS
  Total psychoactive prescribing in people over the age of 65 years has increased comparing 1995 with 2010. Antidepressant [RR = 2.5 (95% CI 2.41-2.59) p < 0.001] and opioid analgesia [RR = 1.21 (1.19-1.24) p < 0.001] prescriptions increased between 1995 and 2010. Hypnotics/anxiolytic [RR = 0.69 (0.66-0.71) p < 0.001] and antipsychotic [RR = 0.83 (0.77-0.88) p < 0.001] prescriptions decreased between 1995 and 2010. An increase in psychoactive prescribing is particularly marked in lower socioeconomic groups. Patients in the least affluent fifth of the population had RR = 1.25 (1.20-1.29) [p < 0.001] of being prescribed one to two psychoactive medications and RR = 1.81 (1.56-2.10) [p < 0.001] of being prescribed three or more psychoactive medications in 2010 compared with those in 1995. The RRs for the most affluent fifth were RR = 1.14 (1.1-1.19) [p < 0.001] and RR = 1.2 (1.01-1.42) [p < 0.001] for one to two, and three or more medications, respectively.
  
  
  CONCLUSIONS
  Psychoactive medication prescribing has increased comparing 1995 with 2010, with increases disproportionately affecting patients in lower socioeconomic groups. The availability of new psychoactive drugs, safety concerns, and economic factors may explain these increases.
authors.affiliation: General Surgery, NHS Tayside, Dundee, UK.
authors.forename: Lloyd D
authors.initials: LD
authors.lastname: Hughes
authors.affiliation: Population Health Sciences, University of Dundee, Dundee, UK.
authors.forename: Lynda
authors.initials: L
authors.lastname: Cochrane
authors.affiliation: Ageing and Health, University of Dundee, Dundee, UK.
authors.forename: Marion E T
authors.initials: ME
authors.lastname: McMurdo
authors.affiliation: Population Health Sciences, University of Dundee, Dundee, UK.
authors.forename: Bruce
authors.initials: B
authors.lastname: Guthrie
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D011307:Drug Prescriptions / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012606:Scotland; D012737:Sex Factors; D012959:Socioeconomic Factors
chemical_list: D011619:Psychotropic Drugs
keywords: older people; prescription; psychoactive prescribing