Magnitude of potentially inappropriate prescribing in Germany among older patients with generalized anxiety disorder

<p>Abstract</p> <p>Background</p> <p>Several medications commonly used to treat generalized anxiety disorder (GAD) have been designated "potentially inappropriate" for use in patients aged ≥65 years because their risks may outweigh their potential benefits. Th...

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Main Authors: Dukes Ellen, Mychaskiw Marko, Berger Ariel, Edelsberg John, Oster Gerry
Format: Article
Language:English
Published: BMC 2009-07-01
Series:BMC Geriatrics
Online Access:http://www.biomedcentral.com/1471-2318/9/31
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author Dukes Ellen
Mychaskiw Marko
Berger Ariel
Edelsberg John
Oster Gerry
author_facet Dukes Ellen
Mychaskiw Marko
Berger Ariel
Edelsberg John
Oster Gerry
author_sort Dukes Ellen
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Several medications commonly used to treat generalized anxiety disorder (GAD) have been designated "potentially inappropriate" for use in patients aged ≥65 years because their risks may outweigh their potential benefits. The actual extent of use of these agents in clinical practice is unknown, however.</p> <p>Methods</p> <p>Using a database with information from encounters with general practitioners (GP) in Germany, we identified all patients, aged ≥65 years, with any GP office visits or dispensed prescriptions with a diagnosis of GAD (ICD-10 diagnosis code F41.1) between 10/1/2003 and 9/30/2004 ("GAD patients"). Among GAD-related medications (including benzodiazepines, tricyclic antidepressants [TCAs], selective serotonin reuptake inhibitors, venlafaxine, hydroxyzine, buspirone, pregabalin, and trifluoperazine), long-acting benzodiazepines, selected short-acting benzodiazepines at relatively high dosages, selected TCAs, and hydroxyzine were designated "potentially inappropriate" for use in patients aged ≥ 65 years, based on published criteria.</p> <p>Results</p> <p>A total of 975 elderly patients with GAD were identified. Mean age was 75 years, and 72% were women; 29% had diagnoses of comorbid depression. Forty percent of study subjects received potentially inappropriate agents – most commonly, bromazepam (10% of all subjects), diazepam (9%), doxepin (7%), amitriptyline (5%), and lorazepam (5%). Twenty-three percent of study subjects received long-acting benzodiazepines, 10% received short-acting benzodiazepines at relatively high doses, and 12% received TCAs designated as potentially inappropriate.</p> <p>Conclusion</p> <p>GPs in Germany often prescribe medications that have been designated as potentially inappropriate to their elderly patients with GAD – especially those with comorbid depressive disorders. Further research is needed to ascertain whether there are specific subgoups of elderly patients with GAD for whom the benefits of these medications outweigh their risks.</p>
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spelling doaj.art-d973da5082c64b8894c20aba1628e5a92022-12-21T22:50:08ZengBMCBMC Geriatrics1471-23182009-07-01913110.1186/1471-2318-9-31Magnitude of potentially inappropriate prescribing in Germany among older patients with generalized anxiety disorderDukes EllenMychaskiw MarkoBerger ArielEdelsberg JohnOster Gerry<p>Abstract</p> <p>Background</p> <p>Several medications commonly used to treat generalized anxiety disorder (GAD) have been designated "potentially inappropriate" for use in patients aged ≥65 years because their risks may outweigh their potential benefits. The actual extent of use of these agents in clinical practice is unknown, however.</p> <p>Methods</p> <p>Using a database with information from encounters with general practitioners (GP) in Germany, we identified all patients, aged ≥65 years, with any GP office visits or dispensed prescriptions with a diagnosis of GAD (ICD-10 diagnosis code F41.1) between 10/1/2003 and 9/30/2004 ("GAD patients"). Among GAD-related medications (including benzodiazepines, tricyclic antidepressants [TCAs], selective serotonin reuptake inhibitors, venlafaxine, hydroxyzine, buspirone, pregabalin, and trifluoperazine), long-acting benzodiazepines, selected short-acting benzodiazepines at relatively high dosages, selected TCAs, and hydroxyzine were designated "potentially inappropriate" for use in patients aged ≥ 65 years, based on published criteria.</p> <p>Results</p> <p>A total of 975 elderly patients with GAD were identified. Mean age was 75 years, and 72% were women; 29% had diagnoses of comorbid depression. Forty percent of study subjects received potentially inappropriate agents – most commonly, bromazepam (10% of all subjects), diazepam (9%), doxepin (7%), amitriptyline (5%), and lorazepam (5%). Twenty-three percent of study subjects received long-acting benzodiazepines, 10% received short-acting benzodiazepines at relatively high doses, and 12% received TCAs designated as potentially inappropriate.</p> <p>Conclusion</p> <p>GPs in Germany often prescribe medications that have been designated as potentially inappropriate to their elderly patients with GAD – especially those with comorbid depressive disorders. Further research is needed to ascertain whether there are specific subgoups of elderly patients with GAD for whom the benefits of these medications outweigh their risks.</p>http://www.biomedcentral.com/1471-2318/9/31
spellingShingle Dukes Ellen
Mychaskiw Marko
Berger Ariel
Edelsberg John
Oster Gerry
Magnitude of potentially inappropriate prescribing in Germany among older patients with generalized anxiety disorder
BMC Geriatrics
title Magnitude of potentially inappropriate prescribing in Germany among older patients with generalized anxiety disorder
title_full Magnitude of potentially inappropriate prescribing in Germany among older patients with generalized anxiety disorder
title_fullStr Magnitude of potentially inappropriate prescribing in Germany among older patients with generalized anxiety disorder
title_full_unstemmed Magnitude of potentially inappropriate prescribing in Germany among older patients with generalized anxiety disorder
title_short Magnitude of potentially inappropriate prescribing in Germany among older patients with generalized anxiety disorder
title_sort magnitude of potentially inappropriate prescribing in germany among older patients with generalized anxiety disorder
url http://www.biomedcentral.com/1471-2318/9/31
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