Prevalence and factors with potentially inappropriate prescribing among older outpatients with depression: a multicentre study across China

TL;DR

This study found that over half of older outpatients with depression in China receive potentially inappropriate prescriptions, with factors like hospital level and polypharmacy contributing to the issue.

Contribution

The study provides new insights into the prevalence and risk factors of potentially inappropriate prescribing for depression in older adults in China.

Findings

The prevalence of potentially inappropriate prescriptions reached 50.42% among older outpatients with depression.

Polypharmacy and treatment in psychiatry departments were strongly associated with higher rates of inappropriate prescriptions.

Abstract

Older outpatients with depression are at high risk for potentially inappropriate prescription (PIP). This investigation sought to determine the frequency and associated factors of PIP within Chinese older adults.

This cross-sectional study used prescription data from older outpatients with depression from 90 hospitals in seven cities in China from January–December 2021. Risk factor identification for PIP employed multivariate logistic regression analysis. Trend assessment was performed through joinpoint regression to calculate the average annual percent change.

The prevalence of PIP reached 50.42%. The top five PIM were alprazolam, clonazepam, olanzapine, lorazepam, estazolam. The prevalence of PIP decreased from 51.56 to 50.99% (average annual percent change = −0.335%). Logistic regression demonstrated that tertiary-level hospital (odds ratio (OR) = 1.215; 95% confidence interval (CI) = 1.100, 1.342, P < 0.001), department of psychiatry (OR = 1.958; 95% CI = 1.855, 2.067, P < 0.001), age ≥80 (OR = 1.069; 95% CI = 1.016, 1.124, P = 0.01), more diseases (OR = 1.209; 95% CI = 1.092, 1.339, P < 0.001), polypharmacy (OR = 1.672; 95% CI = 1.541, 1.814, P < 0.001) exhibited positive links to PIP among older outpatients suffering from depression.

This investigation revealed that the occurrence of PIP in older outpatients with depression is high in China.

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