Antidepressant Overprescribing Appears Common in Elderly
Overprescribing tied to newer antidepressants, non-face-to-face interactions with prescribers
WEDNESDAY, Feb. 6, 2019 (Pharmacist's Briefing) -- Potential antidepressant overprescribing appears to be common among elderly patients and involves mostly newer antidepressants used for nonspecific psychiatric symptoms and subthreshold diagnoses, according to a study published online Jan. 23 in Pharmacology Research & Perspectives.
William V. Bobo, M.D., M.P.H., from the Mayo Clinic in Jacksonville, Florida, and colleagues used data from the Rochester Epidemiology Project medical records-linkage system to assess new antidepressant prescriptions for elderly residents of Olmsted County, Minnesota (2005 to 2012). Health records were reviewed to identify indications for the prescriptions.
The researchers found that potential antidepressant overprescribing occurred in 24 percent of 3,199 incident antidepressant prescriptions during the study period. The suspected overprescribing involved primarily newer antidepressants that were prescribed for nonspecific psychiatric symptoms and subthreshold diagnoses. Factors associated with potential antidepressant overprescribing included nursing home residence; a higher number of comorbid medical conditions and outpatient prescribers; more concomitant medications; greater use of urgent or acute care services in the year preceding the index antidepressant prescription; and being prescribed antidepressants via telephone, email, or patient portal.
"When overprescribing occurred, it was associated with factors representing higher multimorbidity, clinical complexity, and severity -- and with antidepressant prescribing that did not involve face-to-face interaction of patients with prescribers," the authors write.