title: Elderly patients treated with psychotropic medicines admitted to hospital: associated characteristics and inappropriate use.
abstract: OBJECTIVE
  The purpose of this study is to describe the characteristics of older patients treated with psychotropic medicines and the associated factors and to assess their inappropriate use.
  
  
  METHODS
  An observational, prospective study was carried out in 672 elderly patients admitted to seven hospitals for a year. A comparison of sociodemographic characteristics, geriatric variables, multimorbidity and the number of prescribed medicines taken in the preceding month before hospitalization between patients treated with psychotropics and those not treated was performed. To assess factors associated with psychotropics, multivariate logistic regression analyses were performed. Inappropriate use was assessed using the Beers and the STOPP criteria.
  
  
  RESULTS
  A total of 57.5 % patients (median [Q1-Q3] age 81.7 [78.2-86.1], 65.7 % female) were treated with psychotropics (44.2 % anxiolytics, 22.6 % antidepressants and 10.8 % antipsychotics). Independent factors associated with the use of psychotropics were female gender (OR = 2.3; CI 95 %,1.6-3.5), some degree of disability on admission (slight [OR = 2.2; 1.2-4.2], moderate [OR = 3.2, 1.6-6.6], severe [OR = 3.4; 1.4-8] and very severe [OR = 5.1; 2.0-12.8]) and polypharmacy (5-9 medicines [OR = 3.0; 1.3-6.9] and ≥10 medicines [OR = 6.0; 2.7-13.6]). The associated factors varied depending on the different types of psychotropics. In patients treated with psychotropics, the percentage of those with at least one Beers (61.6 %) or at least one STOPP (71.4 %) criteria was significantly higher in comparison with those not treated with psychotropics (30.7 and 47.7 %, respectively, p < 0.001).
  
  
  CONCLUSIONS
  Psychotropics are widely used in the elderly population and often their use is inappropriate. Female gender, a poor functional status and polypharmacy, are the characteristics linked to their use. Interventional strategies should be focused on patients with these characteristics.
authors.affiliation: Clinical Pharmacology Service, Fundació Institut Català de Farmacologia, Hospital Universitari Vall d'Hebron, Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Vidal
authors.affiliation: Clinical Pharmacology Service, Fundació Institut Català de Farmacologia, Hospital Universitari Vall d'Hebron, Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain. aagusti@vhebron.net.
authors.forename: Antonia
authors.identifier: http://orcid.org/0000-0003-4594-1122
authors.initials: A
authors.lastname: Agustí
authors.affiliation: Clinical Pharmacology Service, IDIBELL, Hospital Universitari de Bellvitge, Department of Pathology and Experimental Therapeutics, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Vallano
authors.affiliation: Internal Medicine Service, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain.|Multimorbidity and Elderly Patients Group of the Spanish Society of Internal Medicine, Barcelona, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Formiga
authors.affiliation: Multimorbidity and Elderly Patients Group of the Spanish Society of Internal Medicine, Barcelona, Spain.|Internal Medicine Service, Hospital San Juan De Dios del Aljarafe, Sevilla, Spain.
authors.forename: Antonio Fernández
authors.initials: AF
authors.lastname: Moyano
authors.affiliation: Multimorbidity and Elderly Patients Group of the Spanish Society of Internal Medicine, Barcelona, Spain.|Internal Medicine Service, Hospital General Juan Ramón Jiménez, Huelva, Spain.
authors.forename: Juana
authors.initials: J
authors.lastname: García
authors.affiliation: Multimorbidity and Elderly Patients Group of the Spanish Society of Internal Medicine, Barcelona, Spain.|Internal Medicine Service, Hospital Clínic, Barcelona, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: López-Soto
authors.affiliation: Multimorbidity and Elderly Patients Group of the Spanish Society of Internal Medicine, Barcelona, Spain.|Internal Medicine Service, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
authors.forename: Nieves
authors.initials: N
authors.lastname: Ramírez-Duque
authors.affiliation: Multimorbidity and Elderly Patients Group of the Spanish Society of Internal Medicine, Barcelona, Spain.|Internal Medicine Service, Hospital Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Olga H
authors.initials: OH
authors.lastname: Torres
authors.affiliation: Clinical Pharmacology Service, Fundació Institut Català de Farmacologia, Hospital Universitari Vall d'Hebron, Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.|Multimorbidity and Elderly Patients Group of the Spanish Society of Internal Medicine, Barcelona, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Barbé
authors.affiliation: Multimorbidity and Elderly Patients Group of the Spanish Society of Internal Medicine, Barcelona, Spain.|Internal Medicine Service, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: San-José
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D008297:Male; D019338:Polypharmacy; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012737:Sex Factors; D013030:Spain
chemical_list: D011619:Psychotropic Drugs
keywords: Antidepressants; Antipsychotics; Anxiolytics or hypnotic-sedatives; Polypharmacy; Potentially inappropriate medicines; Psychotropic medicines