PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of brjgenpracRCGP homepageJ R Coll Gen Pract at PubMed CentralBJGP at RCGPBJGP at RCGP
 
Br J Gen Pract. 2010 April 1; 60(573): e156–e162.
PMCID: PMC2845506

Psychotropic drug use among older people in general practice: discrepancies between opinion and practice

Andrea Lasserre, PhD
INSERM, U707, Paris, France; UPMC Université Paris 6, UMR S707, Paris, France
Nadia Younès, MD, PhD
Université Versailles Saint Quentin en Yvelines, Versailles, France
Thierry Blanchon, MD, PhD
INSERM, U707, Paris, France; UPMC Université Paris 6, UMR S707, Paris, France
Inge Cantegreil-Kallen, PhD
Hôpital Broca, Paris, France
Christine Passerieux, MD
Université Versailles Saint Quentin en Yvelines, Versailles, France
Guy Thomas, MD, PhD
INSERM, U707, Paris, France; UPMC Université Paris 6, UMR S707, Paris, France
Christine Chan-Chee, MD
Institut de Veille Sanitaire, Saint-Maurice, France

Abstract

Background

The use of psychotropic drugs has increased over recent years in France. GPs are the first prescribers, especially for older patients.

Aim

To analyse discrepancies between GPs' opinions and practice when prescribing psychotropic drugs to older patients.

Setting

Postal surveys sent to GPs all over mainland France.

Design of study

Cross-sectional postal study.

Method

A questionnaire collected data on characteristics of GPs' practices, their opinions about psychotropic drug consumption in older people, and a full description of their last older patient receiving a psychotropic drug and seen last by the GP on that particular day.

Results

A total of 350 participating GPs saw 2498 patients aged ≥65 years. Among these patients, the prevalence of psychotropic use was 32.1% (803/2498) for anxiolytics/hypnotics, and 17.5% for antidepressants (438/2498). A total of 91% of GPs agreed that it was possible to reduce or stop psychotropic drugs for these patients. Characteristics of 339 patients taking psychotropic drug were reported: 85.8% (291/339) received at least one anxiolytic/hypnotic and 56.9% (193/339) received at least one antidepressant; there were prescribed for more than 1 year in 68.4% (199/291) and 43.5% (84/193) of the cases respectively. GPs stated that it was possible to reduce or stop anxiolytic/hypnotic drugs for only 27% (79/291) of these patients. Barriers to doing this were patients' refusal (79%), and the absence of any local offer of psychotherapy (73%) or alternative therapy (70%).

Conclusion

A mismatch exists between GPs' intent (91%) and practice (27%) regarding reduction of psychotropic prescription in individuals aged ≥65 years. The barriers encountered should be examined further to help physicians improve management of psychotropic prescription.

Keywords: antidepressive, anti-anxiety agents, aged, hypnotics and sedatives, mental disorders, psychotropic drugs

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners