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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Format: | Article |
Language: | English |
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BMC
2009-07-01
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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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id | doaj.art-d973da5082c64b8894c20aba1628e5a9 |
institution | Directory Open Access Journal |
issn | 1471-2318 |
language | English |
last_indexed | 2024-12-14T19:28:33Z |
publishDate | 2009-07-01 |
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series | BMC Geriatrics |
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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