title: Prevalence, Patterns and Predictors of Psychotropic Polypharmacy Among Elderly Individuals with Parkinson's Disease In Long Term Care Settings In The United States.
abstract: BACKGROUND
  Elderly individuals with Parkinson's disease (PD) generally suffer from more than one psychiatric comorbidity, which necessitates the use of concurrent psychotropic medications. To the best of the author's knowledge there are no nationally representative estimates of psychotropic polypharmacy among elderly individuals with PD in the United States (US).
  
  
  OBJECTIVE
  Therefore, the primary objective of this study was to examine the prevalence, patterns and predictors of psychotropic polypharmacy among elderly individuals with PD in the (US).
  
  
  METHODS
  A retrospective, cross-sectional study design with 2004 National Nursing Home Survey (NNHS) and 2007 National Home and Hospice Care Survey (NHHCS) data was used. The analytic sample included elderly (age ≥65 years) individuals with PD. Antidepressants, antipsychotics, sedative/hypnotics, and anti-anxiety medications constituted the psychotropic medication classes. Concurrent use of two or more psychotropic medications was classified as psychotropic polypharmacy.
  
  
  RESULTS
  Approximately 93,648 and 37,439 elderly individuals with PD resided in nursing homes and home health settings respectively. Among elderly nursing home residents with PD, the nationally representative prevalence of psychotropic polypharmacy was 26.28%, whereas, it was 21.36% in the home health setting. Use of antidepressant medications constituted the majority of the psychotropic medication use among both nursing home (48.91%) and home health (40.98%) residents with PD. Multiple logistic regression analyses revealed that specific comorbidities were significantly associated with psychotropic polypharmacy among elderly nursing home residents with PD.
  
  
  CONCLUSIONS
  These findings underscore the importance of evidence-based prescribing when psychotropic medications are used in elderly individuals with PD to reduce unnecessary polypharmacy.
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, Arizona.
authors.forename: Sandipan
authors.initials: S
authors.lastname: Bhattacharjee
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, Arizona.
authors.forename: Lisa
authors.initials: L
authors.lastname: Goldstone
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, Arizona.
authors.forename: Terri
authors.initials: T
authors.lastname: Warholak
mesh_terms: D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D010300:Parkinson Disease / Q000188:drug therapy / Q000453:epidemiology; D019338:Polypharmacy; D015995:Prevalence; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012189:Retrospective Studies; D014481:United States
chemical_list: D011619:Psychotropic Drugs
keywords: Parkinson’s disease; elderly; home health Care; nursing homes; psychotropic drugs