title: Patient, Physician, and Health-System Factors Influencing the Quality of Antidepressant and Sedative Prescribing for Older, Community-Dwelling Adults.
abstract: To identify determinants of potentially inappropriate (PI) antidepressant and anxiolytic/sedative prescribing for older, community-dwelling adults.
  
  
  
  Office visits from the 2010 National Ambulatory Medical Care Survey.
  
  
  
  A cross-sectional study measuring associations between various patient and physician factors and prescribing of PI antidepressants, and PI sedatives among elderly, using Beers 2012/2015 criteria, a clinical decision model, and multivariate logistic regressions.
  
  
  
  Visits by older adults (≥65 years) involving medications were extracted to identify visits with antidepressants and sedatives.
  
  
  
  Black race, asthma, depression, osteoporosis, payment type, consultation time, and computer systems with prescribing support were associated with reduced odds of PI antidepressant prescribing among users. Income, chronic renal failure, diabetes, and obesity were associated with reduced odds of PI sedative prescribing. Female sex, white race, depression, increasing number of medications, and physician specialty were associated with increased odds of PI sedative prescribing.
  
  
  
  Various patient and health-system factors influence the quality of antidepressant and sedative prescribing for older community-dwelling adults. Longer consultations and the use of computer systems with prescribing support may minimize potentially inappropriate antidepressant prescribing. As medication numbers increase, exposure to PI sedatives is more likely, requiring medication review and monitoring.
authors.affiliation: School of Pharmacy, Faculty of Medical Sciences, The University of the West Indies, Champs Fleurs, Trinidad and Tobago.
authors.forename: Rian Marie
authors.identifier: 0000-0002-6490-6472
authors.initials: RM
authors.lastname: Extavour
authors.affiliation: Department of Clinical and Administrative Pharmacy, College of Pharmacy, University of Georgia, Athens, GA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Perri
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002908:Chronic Disease / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000706:statistics & numerical data*; D055695:Electronic Prescribing / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006302:Health Services Research; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D008297:Male; D008511:Medicine; D010817:Physician-Patient Relations; D019338:Polypharmacy; D000067561:Potentially Inappropriate Medication List / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000706:statistics & numerical data; D044469:Racial Groups; D012737:Sex Factors; D012959:Socioeconomic Factors; D013997:Time Factors
chemical_list: D000928:Antidepressive Agents; D006993:Hypnotics and Sedatives
keywords: Pharmaceuticals; aging/elderly/geriatrics; information technology in health; mental health; prescribing/use/costs; quality of care/patient safety (measurement)