Antipsychotic use in the elderly: what doctors say they do, and what they do
Abstract
OBJECTIVE: To review psychiatrists' attitudes and actual practice on the use of typical and atypical antipsychotics in the elderly. METHODS: Audit data were collected from 18-old-age psychiatry units across Australia. The attitudes of old age psychiatrists and their perceptions of the efficacy, tolerability and clinical usefulness of antipsychotics were examined. RESULTS: The medications used for 321 patients were audited, and the attitudes of the 57 prescribing doctors were assessed. All available atypicals were prescribed and reported as more efficacious and clinically useful than typicals. Adverse events perceived by doctors as an obstacle to prescribing were more frequent than reported adverse event rates in product information. All diagnostic groups improved. Off-label use comprised almost 22% in this sample. CONCLUSIONS: Adverse events are impediments to prescribing, more so with typical than atypical antipsychotics. All available atypicals were used and appeared effective in this elderly population.
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In the study comprising views of psychiatrists, adverse events in older people were frequently reported as a barrier to prescribing.
“However, in the study, comprising views of psychiatrists’ adverse events in older people were frequently reported as a barrier to prescribing [79].”
From Stakeholders' views on the use of psychotropic medication in older people: a systematic review (2022) · cites this paper as [79]
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Stakeholders' views on the use of psychotropic medication in older people: a systematic review
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“[79], Australia CS survey 57 psychiatric doctors Inpatients Antipsychotics”
Background
- Authors
- Tiller, J., Ames, D., Brodaty, H., Byrne, G., Chawla, S., Halliday, G., Snowdon, J., Hepworth, G., McArdle, P., & Schweitzer, I.
- Affiliations
- The University of Melbourne (AU)
- UNSW Sydney (AU)
- The University of Queensland (AU)
- Fremantle Hospital (AU)
- Corresponding author
- Tiller, John
- Venue
- Australasian Journal on Ageing
- Publisher
- Wiley
- Published
- 2008-07-29
- Volume
- 27
- Issue
- 3
- Pages
- 134-142
- ISSN
- 0726-4240 (ISSN-L)
- 1440-6381
- 1741-6612
- OpenAlex
- W2010323282
- Cited by
- 8
- References
- 34
- Citations by year
- 2022: 1 · 2017: 1 · 2016: 1 · 2015: 2 · 2012: 1
- FWCI
- 0.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Australian Journal on Ageing (publishedVersion)
- PubMed (publishedVersion)
- Funders
- AstraZeneca
- University of New South Wales
- University of Melbourne
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Social Sciences › Psychology › Clinical Psychology › Historical Psychiatry and Medical Practices
- Keywords
- antipsychotic drugs, elderly patients, typical antipsychotics, atypical antipsychotics, off-label drug use, adverse drug reactions, prescribing attitudes, geriatric psychiatry
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Aging, Attitude of Health Personnel, Australia, Dose-Response Relationship, Drug, Female, Humans, Male, Practice Patterns, Physicians', Psychiatry, Psychotic Disorders, Surveys and Questionnaires, Sensitivity and Specificity, Antipsychotic Agents, Geriatric Assessment, Drug Utilization Review, Risk Assessment, Maximum Tolerated Dose
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