Document Detail


Telephone-based behavioral health assessment for older adults starting a new psychiatric medication.
MedLine Citation:
PMID:  21946801     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVES: : 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.
DESIGN: : Naturalistic cohort study of older adults participating in the Pharmaceutical Assistance Contract for the Elderly (PACE) of the state of Pennsylvania.
SETTING/PARTICIPANTS: : Noninstitutionalized adults in Pennsylvania.
MEASUREMENTS: : 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:
Donovan T Maust; Shahrzad Mavandadi; April Eakin; Joel E Streim; Suzanne Difillipo; Thomas Snedden; David W Oslin
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry     Volume:  19     ISSN:  1545-7214     ISO Abbreviation:  Am J Geriatr Psychiatry     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-09-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9309609     Medline TA:  Am J Geriatr Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  851-8     Citation Subset:  IM    
Affiliation:
Department of Psychiatry, University of Pennsylvania, (DTM, SM, AE, JES, SD, DWO), Philadelphia Veterans Affairs Medical Center and the VISN 4 Mental Illness Research, Education, and Clinical Center (MIRECC), (SM, JES, SD, DWO), Philadelphia, PACE Program, Pennsylvania Department of Aging, Harrisburg (TS), Pennsylvania, USA.
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